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The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on self-management efforts. These decisions not only impact health outcomes but also shape the demand for care, subsequently influencing care costs. Despite the significance of this interplay, current payment schemes often overlook these dynamics. The research focuses on investigating the implications of a novel behavior-based payment scheme, designed to align incentives and establish a direct connection between patients' decisions and care costs. The primary objective is to comprehensively understand whether and how this innovative payment scheme structure influences key stakeholders, including patients, care providers, insurers and overall social welfare.

In this paper, we propose a game-theoretical model to incorporate the performance of self-management with the demand for healthcare service, compare the patient's effort decision for self-management and provider's price decision for healthcare service under a behavior-based scheme with that under two implemented widely payment schemes, that is, co-payment scheme and co-insurance scheme.

Our findings confirm that the behavior-based scheme incentives patient self-management more than current schemes while reducing their possibility of seeking healthcare service, which indirectly induces the provider to lower the price of the service. The stakeholders' utility under various payment schemes is sensitive to the cost of treatment and the perceived health utility of patients. Especially, patient health awareness is not always benefited provider profit, as it motivates patient self-management while diminishing the demand for care.

We provide a novel framework for characterizing behavior-based payment schemes. Our results confirm the need for modification of the current payment scheme to incentivize patient self-management.

The demand for healthcare innovation is increasing, and not much is known about how entrepreneurial firms search for and sell to customers in the highly regulated and complex healthcare market. Drawing on effectuation perspectives, we explore how entrepreneurial digital healthcare firms with disruptive innovations search for early customers in the healthcare sector.

This study uses a qualitative, longitudinal multiple-case design of four entrepreneurial Nordic telehealth firms. In-depth interviews were conducted with founders and senior managers over a period of 27 months.

We find that when customer buying conditions are highly flexible, case firms use effectual logic to generate customer demand for disruptive innovations. However, under constrained buying conditions firms adopt a more causal approach to customer search.

Managers need to gain a deep understanding of target buying environments when searching for customers. In healthcare sector markets, the degree of flexibility customers have over buying can constrain them from engaging in demand co-creation. In particular, healthcare customer access to funding streams can be a key determinant of customer flexibility.

We contribute to effectuation literature by illustrating how customer buying conditions influence decision-making logics of entrepreneurial firms searching for customers in the healthcare sector. We contribute to entrepreneurial resource search literature by illustrating how entrepreneurial firms search for customers beyond their networks in the institutionally complex healthcare sector.

This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.

The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership.

Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries.

To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330

Ineffective management inventory of medical products such as blood and vaccines can create severe repercussions for hospitals, clinics or medical enterprises, such as surgery delays and postponements. Inventory sharing is a form of horizontal collaboration that can provide solutions to key actors of the healthcare supply chain (HSC), yet no prior study reviewed this topic.

This study conducts a systematic literature review of thirty-nine inventory-sharing studies in the context of HSCs published from 2012 until early 2022. The descriptive and thematic analyses include chronological distribution, geographical location, comparison between developed/developing regions, stakeholder and incident analysis.

Thematic analysis classified inventory sharing among five product supply chains (blood, medical supplies, medicines, vaccines and generic medical products). Benefits include shortage reduction, cost minimisation, and wastage mitigation. Barriers include (1) IT infrastructure, (2) social systems, (3) cost and (4) supply chain operations. Perishable inventory policies include Fresher-First (FF), Last-Expire-First-Out (LEFO), First-In-First-Out (FIFO) and First-Expire-First-Out (FEFO). The analysis also showed differences between developed and developing countries. The study identifies several future research opportunities that include (1) product utilisation rate, (2) cost reductions, (3) shortage mitigation and (4) waste reduction.

No prior study has systematically reviewed inventory sharing in HSCs to reveal benefits, barriers, patterns and gaps in the current literature. It makes five propositions and develops a research model to guide future research. The study concludes with theoretical and managerial implications.

The present study used the job-demands and resources (JD-R) framework to understand how the training is transferred to an extreme working context through the analysis of job and personal resources (social support from the leader and colleagues and adaptability). Specifically, the authors tested the mediating role of motivation to transfer in the relationship (1) between the perceived support from the supervisor and colleagues and performance after training and (2) between adaptability and performance in an extreme context of the pandemic crisis – the first peak of COVID-19 in Portugal. Further, an inspection of the factors that predicted knowledge transfer and adaptability under an extreme context was carried out.

To do so, necessary training about the new safety rules regarding the pandemic crisis of COVID-19 was implemented in a healthcare institution as a strategy to help healthcare workers deal with the increasing uncertainty and complexity that was threatening their work. It consisted of three sessions (each with one hour of training) regarding procedures, rules and safety norms. The training occurred in May 2020. Overall, 291 healthcare workers participated in the study and answered one online questionnaire one week after training completion.

The results showed that the motivation to transfer had a significant indirect effect on the relationship between colleagues' and supervisors' support and performance and between adaptability and performance. Additionally, complementary analyses showed that the mediations depended on the levels of self-efficacy in such a way that the indirect relationships were stronger when self-efficacy was higher. Thus, adaptability and support, both from colleagues and the supervisor, are determining factors for knowledge transfer and resultant performance in extreme contexts, such as the COVID-19 pandemic crisis. Lastly, the results showed that the most significant predictors of transference were self-efficacy and the motivation to transfer the learned knowledge. On the other hand, self-efficacy, peer support and the opportunity to use the knowledge were the most significant predictors of adaptability.

These findings provide support for the role of employee motivation to transfer as a mechanism connecting both perceived support and adaptability to performance outcomes under extreme working contexts.

This study, conducted in the middle of the COVID-19 pandemic context – an extreme and uncertain working context – shows the relevance of both job and individual factors to predict employees' adaptability to such contexts.

Various health systems are challenged by a multifaceted crisis of increased service demand and workforce shortages. The effects are devastating and may end up in decreased access to care, poor quality of patient care and extreme demands on the workforce. The introduction of the physician assistant (PA) profession provided an avenue to address such challenges in several countries. In Germany, the integration of PAs has been proceeding slowly.

To understand the integration of the profession in Germany, we conducted 15 expert interviews to reveal how the PA profession is perceived among healthcare experts as well as the barriers and facilitators of integration in inpatient care.

Our results highlight a generally positive perception of PAs, particularly in terms of workload relief and bridging the gap between healthcare professionals. Nonetheless, barriers include resistance from healthcare workers unfamiliar with the PA role, while workforce shortages and collaborative teamwork facilitate integration.

These findings lay the groundwork for potential integration-enhancing strategies in Germany.

Healthcare professionals are key in healthcare organisations but are subject to long working hours and may have to make complex life-and-death decisions. As frontline agents dealing with human lives, giving them a voice is paramount. This study explores the impact of employee voice (assessed based on employee perceptions on how much they are consulted and how much influence they have on task-related decisions) on health professionals' work engagement and burnout when mediated by relational outcomes (perceived organisational support, workplace trust, workplace recognition and meaningful work).

A sample of 3,266 health professionals retrieved from the European Working Condition Survey was used. The quantitative analysis was performed using the partial least square structural equation modelling and multiple regression analyses.

The results indicate that employee voice has a direct positive impact on work engagement, but employee voice's direct effects on burnout still need to be confirmed. Relational outcomes are found to mediate the relationship between employee voice and burnout (decreasing it) and between employee voice and work engagement (increasing it).

Practices of employee voice in the workplace are fundamental to promoting health professionals' well-being. Trust, recognition, support and the feeling of doing meaningful work increase the influence of employee voice, especially in reducing the levels of burnout.

This is the first study that assesses, at a European level, the importance that ‘giving health professionals a voice' has on crucial employee outcomes: work engagement, burnout and relational outcomes.

Health care organizations’ decision-making for the future relies on anticipating changes. Reliable predictions are becoming increasingly difficult, creating anxiety and requires long-term adaptive planning to cope with unforeseen circumstances. The purpose of this study is to gain insights into the awareness of uncertainties that decision makers in healthcare have, particularly when making long-term investments.

This is a qualitative study with an explorative purpose. The data were collected through semi-structured and open interviews with board members of long-term care organizations.

The study revealed that respondents are most uncertain about the future financing of their real estate system. Another concern revealed is about the shortage of care professionals combined with an increasing demand for future care. Despite most decision makers do recognize uncertainties during the decision-making process, decision makers hardly address the level of these uncertainties. Although this study did find that some decision makers are aware of deep uncertainties, in terms of “unknown unknowns,” they have no actual approaches for dealing with such situations.

Decision makers at healthcare organizations are uncertain as to their ability to anticipate technological, economic, social and political developments, as well as predict future healthcare system transformations. Some decision makers are aware of deep uncertainties, in terms of “unknown unknowns” and “unidentified unknowns,” but they lack an actual approach to deal with such situations. This study examines how strategies adapt to unforeseen developments or how to deal with deep uncertainties in healthcare as complex adaptive system.

The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate how the main reform foci of productivity and quality are represented, with a specific focus on the patient.

Drawing on critical discourse analysis (CDA), the authors conduct a longitudinal study (2007–2018) of healthcare reporting foci across the five administrative regions responsible for public hospitals in Denmark. The study analyses sixty annual reports and draws on contemporary reform documents over this period. CDA enables a micro-textual analysis, combined with macro-insights and discussions on social practice.

The findings show complex webs of presentation strategies, but in particular two changes occur during the period. First, the patient is centred throughout but the framing changes from productivity and waiting lists to quality and dialogue. Second, in the first years, the regions present themselves as actively highlighting financial and quality concerns, which changes to a passive and indirect form of presentation steered by indicators and patient legislation enforced by central government. This enhances passivity and distance in healthcare regional non-financial reporting where the regions seek to conform to such demands. Simultaneously, however, the authors find a tendency to highlight very different local initiatives, which shows an attempt to go beyond a pure automatic mode of reporting found in earlier studies.

Responding to the literature on both healthcare and financial reporting, this study identifies novel links between micro-level texts and macro-level social practices, enabling insights into the potentially intertwined impacts of public-sector reporting. The authors offer insights into the complexity of the construction of non-financial reporting in the public sector, which has a wider impact and different intentions than private-sector reporting.

Many town centres in England exhibit high retail property vacancies and require regeneration. Several alternatives for the replacement of town centre retail (TCR) have been suggested, one of which is healthcare. The healthcare sector in England is in distress, with the National Health Service (NHS) tackling extensive patient waiting lists, whilst operating from an ageing estate. This paper is an introductory study that uses seven carefully selected personalised surveys to raise academic awareness of the importance and potential of integrating healthcare into town centres and calls for large-scale research to establish the statistical validity of the reported observations.

This study is developed from an interpretative standpoint. Through semi-structured interviews with key stakeholders specific to retail-to-healthcare conversions, this study reports stakeholders' perspectives on opportunities and limitations for such conversions to give direction for large statistical research in the future.

All participants support the integration of healthcare into town centres and agreed that diagnostic services, mental health support and primary care services are appropriate for provision within town centres. The participants advocate large-scale change in town centres in England, with integrated healthcare co-located with complementary services to fit with wider regeneration plans. Participants prefer adaptation of existing buildings where technically feasible and emphasise the importance of obtaining the buy-in of other stakeholders whilst expressing concerns about the uncertainty of capital funding availability.

This is the first study to analyse the practice of retail-to-healthcare conversions in town centres. These are still rare in England and projects are complex. The market experience is limited, and thus, the literature is scarce. This study fills this void and provides a starting point for future quantitative research in this area and informs the new town-planning policies.