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Article
Publication date: 31 August 2012

Mohammad Nurunnabi and Syed Kamrul Islam

The purpose of this paper is to examine the perceived Bangladesh privatized healthcare sector accountability gap.

Abstract

Purpose

The purpose of this paper is to examine the perceived Bangladesh privatized healthcare sector accountability gap.

Design/methodology/approach

Data were collected from 533 patients using services in 45 Dhaka city privatized hospitals. A questionnaire was designed based on 60 patient focus study group and the literature.

Findings

Structural equation modeling provides a comprehensive picture that allows healthcare constructs and accountability to be tested. The goodness‐of‐fit statistics supported the four factors of professionals, administration and management, legal enforcement, ethics and government, which were significantly associated with accountability. Despite Bangladeshi privatized healthcare growth, the study revealed that accountability mainly depends on government initiatives and effectively implementing existing laws.

Research limitations/implications

The study covered one Bangladesh city (Dhaka) owing to resource constraints. Qualitative methods may have enriched the findings.

Practical implications

The accountability dimensions may be applicable to other countries to examine the perceived accountability gap. The study looked at the current Bangladesh privatized healthcare sector. Major issues of Bangladesh privatized healthcare accountability are discussed and recommendations for policymakers are suggested to improve the current circumstances.

Originality/value

The study is the first of its kind to examine accountability among privatized healthcare providers in developing countries. Patients’ accountability views require urgent attention from policy makers.

Details

International Journal of Health Care Quality Assurance, vol. 25 no. 7
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 27 August 2020

Timothy J. Vogus, Andrew Gallan, Cheryl Rathert, Dahlia El-Manstrly and Alexis Strong

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions…

Abstract

Purpose

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

Design/methodology/approach

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

Findings

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

Originality/value

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

Details

Journal of Service Management, vol. 31 no. 5
Type: Research Article
ISSN: 1757-5818

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Content available

Abstract

Details

Leadership in Health Services, vol. 24 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

Content available
Article
Publication date: 2 May 2008

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 3
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 12 June 2019

Giuseppe Grossi, Kirsi-Mari Kallio, Massimo Sargiacomo and Matti Skoog

The purpose of this paper is to synthesize insights from previous accounting, performance measurement (PM) and accountability research into the rapidly emerging field of…

Abstract

Purpose

The purpose of this paper is to synthesize insights from previous accounting, performance measurement (PM) and accountability research into the rapidly emerging field of knowledge-intensive public organizations (KIPOs). In so doing, it draws upon insights from previous literature and other papers included in this special issue of Accounting, Auditing and Accountability Journal.

Design/methodology/approach

The paper reviews academic analysis and insights provided in the academic literature on accounting, PM and accountability changes in KIPOs, such as universities and healthcare organizations, and paves the way for future research in this area.

Findings

The literature review shows that a growing number of studies are focusing on the hybridization of different KIPOs, not only in terms of accounting tools (e.g. performance indicators, budgeting and reporting) but also in relation to individual actors (e.g. professionals and managers) that may have divergent values and thus act according to multiple logics. It highlights many areas in which further robust academic research is needed to guide developments of hybrid organizations in policy and practice.

Research limitations/implications

This paper provides academics, regulators and decision makers with relevant insights into issues and aspects of accounting, PM and accountability in hybrid organizations that need further theoretical development and empirical evidence to help inform improvements in policy and practice.

Originality/value

The paper provides the growing number of academic researchers in this emerging area with a literature review and agenda upon which they can build their research.

Details

Accounting, Auditing & Accountability Journal, vol. 33 no. 1
Type: Research Article
ISSN: 0951-3574

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Article
Publication date: 1 March 2008

Alan K. Styles and William R. Koprowski

U.S. hospitals face calls for accountability from regulators, professionals, academics and consumers. Transparency and wider dissemination in reporting of financial…

Abstract

U.S. hospitals face calls for accountability from regulators, professionals, academics and consumers. Transparency and wider dissemination in reporting of financial performance is an integral component of accountability. This paper investigates the extent to which U.S. hospitals have used the Internet to disseminate financial information and demonstrate accountability to the communities they purport to serve. The authors examine the availability of financial information on the websites of the American Hospital Association’s 100 Most Wired healthcare systems. Results of this investigation indicate that the vast majority of the most technically competent U.S. hospitals have yet to embrace the Internet as a tool for financial disclosure. The findings highlight a lack of transparency and an accountability gap for U.S. healthcare systems.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 20 no. 3
Type: Research Article
ISSN: 1096-3367

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Book part
Publication date: 24 July 2020

Soo-Hoon Lee, Thomas W. Lee and Phillip H. Phan

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on…

Abstract

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

Details

Research in Personnel and Human Resources Management
Type: Book
ISBN: 978-1-80043-076-1

Keywords

Content available
Article
Publication date: 22 December 2020

Jitse Jonne Schuurmans, Nienke van Pijkeren, Roland Bal and Iris Wallenburg

The purpose of this paper is to explore the formation and composition of “regions” as places of care, both empirically and conceptually.

Abstract

Purpose

The purpose of this paper is to explore the formation and composition of “regions” as places of care, both empirically and conceptually.

Design/methodology/approach

This paper draws on action-oriented research involving experiments aimed at designing, implementing and evaluating promising solutions to the entwined problems of a burgeoning elderly population and an increasing shortage of medical staff. It draws on ethnographic research conducted in 14 administrative areas in the Netherlands, a total of 273 in-depth interviews and over 1,000 h of observations.

Findings

This research challenges the understanding of a healthcare region as a clearly bounded topological area. It shows that organizations and professionals collaborate in a variety of different networks, some conterminous with the administrative region established by policymakers and others not. These networks are by nature unstable and dynamic. Attempts to form new regional collaborations with neighbouring organizations are complicated by existing healthcare governance and accountability structures that position organizations as competitors.

Practical implications

Policymakers should take the pre-established partnerships of healthcare organizations into account before delineating the area in which regionalization is meant to take place. A better alignment of governance and accountability structures is also needed for regionalization to occur in healthcare.

Originality/value

This paper combines insights from valuation studies with sociogeographical literature and provides a framework for understanding the assembling and disassembling of “regions”.

Details

Journal of Health Organization and Management, vol. 35 no. 2
Type: Research Article
ISSN: 1477-7266

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Book part
Publication date: 22 July 2021

Iris Wallenburg, Anne Essén and Roland Bal

Performance metrics have become widely used and much lamented – about tools for measuring healthcare quality. In this paper, the authors reflect on the development and use…

Abstract

Performance metrics have become widely used and much lamented – about tools for measuring healthcare quality. In this paper, the authors reflect on the development and use of performance metrics in healthcare regulation and clinical practice. Studying multi-actor settings of performance measurement systems in healthcare in Sweden and the Netherlands, the authors show how regulatory agencies (i.e., the inspectorate and national registries), patients, hospitals, and practitioners engage in the constitution of healthcare practices through developing performance indicators that form the input for ranking, ensuing intensive dialogues on what should be measured and accounted for, and to what effects. The authors analyze this process as caring for numbers. The authors discern two practices of caring for numbers: validating and contexting. Validating refers to the practices of making numbers reflect those practices they intend to depict; contexting is about how with the use of numbers specific contexts of healthcare are built. These processes together emphasize the performative character of numbers as well as the reflexive uses of performativity. The paper shows how collaborative and rather pragmatic practices of caring for numbers co-construct specific practices of healthcare. Though this reflexive entanglement of production and use of numbers actors not only constitute specific performance metrics and ranking practices but also perform healthcare.

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Article
Publication date: 23 November 2010

Paulino Silva and Aldónio Ferreira

There is a growing interest in research focusing on performance management practices in the public sector, but research is still limited with regards to public primary…

Abstract

Purpose

There is a growing interest in research focusing on performance management practices in the public sector, but research is still limited with regards to public primary healthcare services (PHSs), which play an important role in national healthcare systems. These organisations are frequently criticised for alleged poor performance management practices and misuse of resources, though such claims are not always substantiated. The purpose of this study is to examine performance management practices in public PHSs.

Design/methodology/approach

Three case studies of PHSs organisations were conducted resulting in interview material and archival data. Otley's performance management framework was used to examine the data.

Findings

It is found that the performance management systems of the studied PHSs were disjoint and lacked consistency and coherence. Lack of direction and motivational were key issues in PHSs. Furthermore, the observations indicate that vertical controls between PHSs and parent organisation were weak and accountability poor.

Research limitations/implications

Generalisability of findings and social desirability bias are the important limitations. A key research implication is that the conceptual framework adopted can be meaningfully used to generate insights into performance management issues in public sector healthcare organisations.

Practical implications

The study highlights the implications of the poor design and use of performance management systems and highlights areas for improvement in the organisations studied, and potentially across the sector.

Originality/value

This study is the first to draw upon Otley's performance management framework to examine performance management practices in PHSs and to demonstrate its usefulness in this context.

Details

Qualitative Research in Accounting & Management, vol. 7 no. 4
Type: Research Article
ISSN: 1176-6093

Keywords

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