Search results

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

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.

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.

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.

Employee recognition systems are ubiquitous in organizations (WorldatWork, 2019) and have positive effects on work outcomes (e.g. Stajkovic and Luthans, 2001). However, psychologically meaningful recognition relies on the recognition giver being motivated to observe and recognize coworkers. Crises such as the COVID-19 pandemic may impact recognition giving in varying ways, yet little research considers this possibility.

This longitudinal field study examined the impact of the COVID-19 crisis on recognition and acknowledgment giving among frontline and nonfrontline healthcare workers at daily and aggregated levels. We tested the relationships between publicly available daily indicators of COVID-19 and objectively measured daily recognition and acknowledgment giving within a web-based platform.

We found that the amount of daily recognition giving was no different during the crisis compared to the year before, but fewer employees gave recognition, and significantly more recognition was given on days when COVID-19 indicators were relatively high. In contrast, the amount of acknowledgment giving was significantly lower in frontline staff and significantly higher in nonfrontline staff during the pandemic than before, but on a daily-level, acknowledgment was unrelated to COVID-19 indicators.

Our results suggest that organizational crises may at once inhibit and stimulate employee recognition and acknowledgment.

Our research is the first to empirically demonstrate that situational factors associated with a crisis can impact recognition giving behavior, and they do so in ways consistent with ostensibly contradictory theories.

Lean Six Sigma (LSS) implementation follows a structured approach called define-measure-analyze-improve-control (DMAIC). Earlier research about its application in emergency healthcare services shows that it requires organizational transformation, which many healthcare setups find difficult. The Kotter change management model facilitates organizational transformation but has not been attempted in LSS settings till now. This study aims to integrate the LSS framework with the Kotter change management model to come up with an integrated framework that will facilitate LSS deployment in emergency health services.

Two-stage Delphi method was conducted by using a literature review. First, the success factors and barriers of LSS are investigated, especially from an emergency healthcare point of view. The features and benefits of Kotter's change management models are then reviewed. Subsequently, they are integrated to form a framework specific to LSS deployment in an emergency healthcare set-up. The elements of this framework are analyzed using expert opinion ratings. A new framework for LSS deployment in emergency healthcare has been developed, which can prevent failures due to challenges faced by organizations in overcoming resistance to changes.

The eight steps of the Kotter model such as establishing a sense of urgency, forming a powerful guiding coalition, creating a vision, communicating the vision, empowering others to act on the vision, planning for and creating short-term wins, consolidating improvements and producing still more change, institutionalizing new approaches are derived from the eight common errors that managers make while implementing change in the institution. The study integrated LSS principles and Kotter’s change management model to apply in emergency care units in order to reduce waste and raise the level of service quality provided by healthcare companies.

The present study could contribute knowledge to the literature by providing a framework to integrate lean management and Kotter's change management model for the emergency care unit of the healthcare organization. This framework guides decision-makers and organizations as proper strategies are required for applying lean management practices in any system.

The proposed framework is unique and no other study has prescribed any integrated framework for LSS implementation in emergency healthcare that overcomes resistance to change.

This study investigated the relationship between last-mile distribution or delivery (LMD) and commodity access through the mediating role of commodity availability and commodity security and the moderating effect of supply chain integration (SCI).

The study adopted the survey research design and employed the questionnaire instrument in collecting primary data from respondents in Eastern Regional Health Institutions in Ghana. The total number of valid responses received was 204. The partial least squares structural equation modeling (PLS-SEM) approach was adopted to analyze the relationship between the study variables.

The findings showed that there is a positive and significant relationship between LMD and commodity availability as well as LMD and commodity security. Moreover, while the relationship between commodity availability and commodity access is positive and significant, that between commodity security and commodity access is positive but insignificant. Furthermore, there is a positive and statistically significant relationship between LMD and commodity access. The study discovered that the interaction between LMD and commodity access is insignificant and negatively affected by SCI.

To the best of the authors' knowledge, no previous studies have empirically verified the effect of LMD on commodity access in the presence of mediating factors such as commodity availability and commodity security and SCI as the moderating factors.

Blockchain technology enhances information management in healthcare supply chains by securing healthcare information and providing medical resource traceability. However, there is no decision framework to support blockchain implementation for managing information, especially in emerging economies’ healthcare supply chains. This paper develops a hierarchical decision model for implementing blockchain technology for information management in emerging economies’ healthcare supply chains.

This study uses 20 health supply chain experts in Ghana to rank 17 decision criteria for implementing blockchain for healthcare information management using the best-worst method (BWM) multi-criteria decision technique.

The results show that “security” and “privacy,” “infrastructural facility” and “presence of training facilities” are the top three critical factors impacting blockchain adoption in the health supply chain for healthcare information management. Other sub-factors are prioritized.

To implement blockchain effectively to enhance information management in the healthcare supply chain, health institutions, blockchain technology providers and state authorities should concentrate on the highly critical factors extracted from the study.

This is the first study that develops a hierarchical decision model for implementing blockchain technology in emerging economies' health supply chains.