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This study aims at evaluating the technical efficiency (TE) of healthcare systems in the Arab region and exploring the key factors that affect the efficiency performance.

The study applies a two-stage Data Envelopment Analysis (DEA) approach to a sample of 20 Arab countries. In the first stage, a DEA model is used to calculate the TE scores of the examined healthcare systems in 2019 and 2010, following both the output and input orientations of efficiency. In the second stage, a censored Tobit model is estimated to investigate the determinants of healthcare efficiency.

DEA results of 2019 indicate that achievable efficiency gains of the Arab countries range from 0.4% to 16% under the output and input orientations, respectively. Six countries are efficient under both orientations. Although the average efficiency scores of the Arab countries have deteriorated between 2010 and 2019, Djibouti and Sudan had the greatest efficiency improvements between the two years. Bahrain, Mauritania, Morocco and Qatar proved to be efficient in 2010 and 2019 under the two orientations of efficiency and according to the two DEA specifications followed. The Tobit model reveals that corruption and government health expenditure tend to have an adverse impact on healthcare efficiency.

The author evaluates healthcare efficiency and healthcare's efficiency determinants in the Arab countries. Regardless Arab countries' diversity, these countries are facing common health challenges, including diminishing role of governments in healthcare financing; increased out-of-pocket healthcare spending; poor healthcare outputs and prevalence of health inequities resulting from weak governance institutions. Comparing the efficiency of healthcare systems between 2010 and 2019 gives insights on the potential impact of the Arab spring uprisings on healthcare efficiency. Moreover, examining the determinants of healthcare efficiency allows for better understanding of how to improve the efficiency of healthcare systems in the region.

The main aim of the study was to measure and assess the efficiency of the healthcare system in Poland.

An output-oriented Data Envelopment Analysis model with a 2-years window analysis extension was used between 2013 and 2018. The analysis was completed with a determination of the sources of productivity changes (between the first and last year of the study period) and factors that influence efficiency.

Efficient regions have been identified and the spatial diversity in their efficiency was confirmed. The study identified individual efficiency trends together with “all-windows” best and worst performers. Using panel modeling, it was confirmed that the efficiency of health protection is influenced by, among others, accreditation certificates, the length of the waiting list or the number of medical personnel.

Although the analysis was conducted at the voivodeship level (NUTS2), which was fully justified, it would be equally important to analyze data with a lower aggregation level. It would be extremely valuable from the perspective of difficulties faced by the healthcare system in Poland.

The identification of areas and problems affecting the efficiency of the healthcare system in Poland may also be a hint for other countries with similar system solutions that also struggle with the same problems.

The paper explains the efficiency of the country's healthcare system while also paying attention to changes in its level, factors influencing it, spatial diversity and impact on the sector functioning.

Healthcare management efficiency has become a golden goal in the operations of modern healthcare organisations across zones and cultures. This study aims to investigate five dimensions of Ouchi’s theory Z approach, mutual organisational trust, long-term employment/job security, employee participatory decision-making, employee well-being and generalised career path, concerning healthcare efficiency in government tertiary hospitals during COVID-19 period.

The probability sampling strategy was adopted among 300 participants of the hospitals in the healthcare workforce of the study population. The study adopted multiple scales on the identified variables of theory Z and employed principal component analysis to evaluate the components of Ouchi’s Theory Z in relation to healthcare efficiency among the workforce of tertiary hospitals in Lagos State, Nigeria.

The outcome of this study shows that all the dimensions were significantly related to healthcare efficiency in the study hospitals. It depicts that mutual trust among employees has a positive influence on the efficiency of healthcare management in government tertiary hospitals, and long-term employment opportunity has a significant impact on the efficiency of healthcare management in government tertiary hospitals. Employee participatory decision-making is essential to the efficiency of healthcare management in government tertiary hospitals. Employee well-being is fundamental to the efficiency of healthcare management in government tertiary hospitals. Generalised career path of healthcare personnel has a tremendous impact on the efficiency of healthcare management in government tertiary hospitals.

This study is limited to healthcare employees in Lagos State, Nigeria. The implication is that as old as Ouchi’s theory, its relevance remains green in the heart of contemporary organisations today even in healthcare facilities in Nigeria which aids the management of the global pandemic, COVID-19 outbreak.

The study shows that Ouchi’s theory Z approach that combines the Japanese and American patterns of organisational management is highly relevant in the operations and management of government hospitals in Nigeria to date even in the era of COVID-19, the global pandemic season.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

The purpose of this paper is to measure the efficiency of ISO 9001-certified public healthcare center in Jakarta, Indonesia and examine the impact of “re-certification“ on the efficiency.

The sample of the research is 30 ISO 9001-certified district public healthcare centers in Jakarta. The data envelopment analysis (DEA) and the Man–Whitney U test were applied.

The research result showed that there is a variation in efficiency values of ISO 9001-certified public healthcare centers that this research studied. There are only 23 percent of the public healthcare centers that can be categorized as the technically efficient public healthcare center. Furthermore, this research also found that there are no significant efficiency value differences among the groups of public healthcare center based on the number of “re-certification” the center experienced.

This research only involved ISO 9001-certified public healthcare center from Jakarta, Indonesia.

Registering ISO 9001 for the public healthcare center does not guarantee that the public healthcare center will have better efficiency. The government and the public healthcare center management should ensure that the ISO 9001 implementation method used by the public healthcare center is appropriate for improving the efficiency of the public healthcare center.

There is a lack of research that studied the efficiency of ISO 9001-certified public healthcare center. Furthermore, there is no research that investigates the effect of “re-certification“ on efficiency. This research fulfills the literature gaps.

The purpose of this paper is to determine the characteristics of healthcare facilities that produce the most efficient inpatient orthopedic surgery using a large-scale medical claims database in Japan.

Reimbursement claims data were obtained from April 1 through September 30, 2014. Input-oriented Banker-Charnes-Cooper model of data envelopment analysis (DEA) was employed. The decision-making unit was defined as a healthcare facility where orthopedic surgery was performed. Inputs were defined as the length of stay, the number of beds, and the total costs of expensive surgical devices. Output was defined as total surgical fees for each surgery. Efficiency scores of healthcare facilities were compared among different categories of healthcare facilities.

The efficiency scores of healthcare facilities with a diagnosis-procedure combination (DPC) reimbursement were significantly lower than those without DPC (p=0.0000). All the efficiency scores of clinics with beds were 1. Their efficiency scores were significantly higher than those of university hospitals, public hospitals, and other hospitals (p=0.0000).

This is the first research that applied DEA for orthopedic surgery in Japan. The healthcare facilities with DPC reimbursement were less efficient than those without DPC. The clinics with beds were the most efficient among all types of management bodies of healthcare facilities.

The purpose of this study is to comprehensively explore the impact of digitalization on healthcare supply chains (HcSCs). It seeks to understand how digital technologies enhance efficiency, transparency and responsiveness within these complex logistical systems. The study aims to provide a holistic view of the transformative potential of digitalization in the healthcare sector, with a particular focus on improving patient care and streamlining operational processes.

This research employs a systematic review methodology, carefully curating a selection of 45 relevant articles from 66 articles rigorously screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to provide a holistic view. It follows established systematic review protocols, incorporating a meticulous search strategy and precise keyword selection. The chosen research design enables a comprehensive examination of the existing body of knowledge concerning digital platforms, real-time tracking technologies, transparency and responsiveness in the context of HcSCs.

The findings of this study emphasize the pivotal role of digital technologies in reshaping HcSCs. Digital platforms, real-time tracking systems and technological integrations substantially enhance efficiency, transparency and responsiveness. Data-driven decision-making, improved communication and agile responses to dynamic demands are key aspects. These findings underscore the transformative impact of digitalization on healthcare logistics, emphasizing the potential for streamlined operations, enhanced patient care and more efficient resource allocation.

Despite the systematic methodology, this study is subject to certain limitations. It relies on existing literature, which may not cover the most recent developments in the rapidly evolving field of digital HcSCs. Furthermore, the study may be influenced by publication bias. The implications suggest the need for continued research to explore emerging digital technologies and their effects on healthcare logistics, ensuring that supply chains remain agile and responsive.

The practical implications of this research are significant for HcSC managers with insights into digital technologies to enhance transparency and collaboration and improve resource visibility. The integration of data analytics can lead to more effective inventory management and demand forecasting. Blockchain (BC) technology can ensure transparent and secure transactions, fostering trust among stakeholders. For practitioners, this research offers actionable guidance for navigating the digital age, promoting operational efficiency and ensuring a consistent supply of essential medical products. Researchers can use these insights as a foundation for further exploration into the potential of digitalization in HcSCs.

The social implications of digitalization in HcSCs are far-reaching. They encompass improved patient care, as digital technologies enhance the efficiency, transparency and responsiveness of supply chains. This translates to better access to critical medical supplies, potentially reducing healthcare disparities and benefiting underserved populations. Enhanced patient safety is a significant social outcome, as transparent and secure transactions enabled by technologies like BC mitigate the risks associated with counterfeit medications. Furthermore, digitalization builds trust among stakeholders, promotes accountability and fosters resilient healthcare systems, which are capable of responding effectively to crises. It also has the potential to make healthcare more affordable, contributing to increased healthcare access and transparency in decision-making.

The originality and value of this study lie in its comprehensive synthesis of diverse findings related to digitalization in HcSCs. While prior studies have examined isolated facets of digital technology adoption, this research provides a comprehensive overview. It contributes to a deeper understanding of the transformative potential of digitalization within the healthcare sector, offering practical approaches to enhance patient care and streamline operations.

The fundamental concern of this research study is to learn the quality and efficiency of US healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the US healthcare system with those of other developed nations.

The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e. GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in US healthcare.

At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The US healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology‐induced costs and consumer behavior.

Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the “waste” from the system. Trend analyses are presented that display the crucial relationship between economic growth and healthcare spending.

There are many articles and reports published on the US healthcare system. However, very few articles have explored, in a comprehensive manner, the links between the economic indicators and measures of the healthcare system and how to reform this system. As a result of the US healthcare system's complex structure, process map and cause‐effect diagrams are utilized to simplify, address and understand. This study linked top‐level factors, i.e. the societal, government policies, healthcare system comparison, potential reformation solutions and the enormity of the recent trends by presenting serious issues associated with US healthcare.

This study used Data Envelopment Analysis (DEA) to measure and evaluate the operational efficiency of 26 isolation hospitals in Egypt during the COVID-19 pandemic, as well as identifying the most important inputs affecting their efficiency.

To measure the operational efficiency of isolation hospitals, this paper combined three interrelated methodologies including DEA, sensitivity analysis and Tobit regression, as well as three inputs (number of physicians, number of nurses and number of beds) and three outputs (number of infections, number of recoveries and number of deaths). Available data were analyzed through R v.4.0.1 software to achieve the study purpose.

Based on DEA analysis, out of 26 isolation hospitals, only 4 were found efficient according to CCR model and 12 out of 26 hospitals achieved efficiency under the BCC model, Tobit regression results confirmed that the number of nurses and the number of beds are common factors impacted the operational efficiency of isolation hospitals, while the number of physicians had no significant effect on efficiency.

The limits of this study related to measuring the operational efficiency of isolation hospitals in Egypt considering the available data for the period from February to August 2020. DEA analysis can also be an important benchmarking tool for measuring the operational efficiency of isolation hospitals, for identifying their ability to utilize and allocate their resources in an optimal manner (Demand vs Capacity Dilemma), which in turn, encountering this pandemic and protect citizens' health.

Despite the intensity of studies that dealt with measuring hospital efficiency, this study to the best of our knowledge is one of the first attempts to measure the efficiency of hospitals in Egypt in times of health' crisis, especially, during the COVID-19 pandemic, to identify the best allocation of resources to achieve the highest level of efficiency during this pandemic.

The purpose of this paper is to consider the efficiency of US healthcare in an international context. The paper emphasizes the concept of efficiency and explores implications for pharmaceutical marketing.

Literature review, economic theory, secondary data and bivariate regression were used to describe and evaluate US healthcare spending and pharmaceutical marketing.

US healthcare spending is inordinately high as a share of gross domestic product within developed countries and this is associated with a relatively high share of private finance. But public sector finance is displacing private payment and this trend is especially pronounced for pharmaceuticals. Public finance combined with fiscal pressure can be expected to curb use of pharmaceutical detailing and other forms of marketing. The limits of affordability are not well assessed and socio‐economic institutions to facilitate decisions about present and future costs have yet to evolve.

This paper provides a macro perspective for healthcare finance and the marketing of pharmaceuticals. It pioneers analysis of economics and international healthcare systems integrated with the foundations of demand for pharmaceutical marketing.