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Book part
Publication date: 10 August 2017

Jacob Chao-Lun Huang

Since health behaviors of elderly Asian Americans are often underreported, the study, based on the health behavioral model (Andersen’s model), was to examine if there is a…

Abstract

Since health behaviors of elderly Asian Americans are often underreported, the study, based on the health behavioral model (Andersen’s model), was to examine if there is a reciprocal relationship between healthcare utilization and health outcomes, and how social characteristics play their role in this relationship between US-born and foreign-born elderly Asian Americans.

Using structural equation modeling, this research examined the proposed hypotheses which consisted of direct and indirect effects among health outcomes, healthcare utilization and social characteristics, as well as the disparities of the effects between US-born and foreign-born elderly Asian Americans (65 + ). A sample size of elderly Asian Americans was divided into a US-born group (N = 1,305) and a foreign-born group (N = 4,902) from the National Health Interview Survey (NHIS) 1998–2012. Health outcomes consisted of current health status and health change. Healthcare utilization included general doctor visit, ER, and mental health professional visit. Social characteristics of population included predisposing characteristics (such as age, sex, marital status, and region of residency) and enabling resources (such as education, family size, and family income).

Results from the study indicated that first, there was a reciprocal relationship between health outcomes and healthcare utilization for both groups. Second, predisposing characteristics had a direct effect on health outcomes, and enabling resources had an indirect effect on health outcomes via healthcare utilization. In addition, living in the West had both direct and indirect effects on health outcomes. Third, regarding disparities of the effects between both groups, the US-born elderly are more likely to attain health benefits from healthcare utilization and their social characteristics than the foreign-born. As a result, the interactive relationship between health outcomes, healthcare utilization, and social characteristics, as well as disparities of healthcare outcomes through health utilization and social characteristics for elderly Asian Americans is highlighted.

First, due to the design of NHIS, this research was limited to fully present the needs and more characteristics of elderly Asian Americans. This shows the great need for a large scale, representative study for health behaviors of elderly Asian Americans. Second, in the dataset, the study was limited to explore health behaviors of elderly Asian Americans into each Asian ethnic subgroup. Since the culture of Asian Americans is heterogeneous, it is recommended that future research can explore differences and commonalities of the health behaviors between Asian subgroups. Third, based on the health behavioral model and the design of the dataset, this study was limited to illustrate variations of life experiences between both groups. These differences regarding their needs and desires for healthcare services and health outcomes can become an important foundation for service providers and policy makers to provide appropriate services that improve the quality of the later lives of elderly Asian Americans.

First, the study applied the health behavioral model and proved that the effect of healthcare utilization and social characteristics on health outcomes is greater for the US-born elderly Asian Americans than for the foreign-born. Second, this study confirmed that the healthcare services in US society are still beneficial for the health outcomes of elderly Asian Americans. Third, the study found that when family is used to explain the social behaviors of elderly Asian Americans, researchers need to be more careful to identify various family factors in accordance to its dynamics, such as interpersonal relationship, material supply, and emotional support.

Details

Health and Health Care Concerns Among Women and Racial and Ethnic Minorities
Type: Book
ISBN: 978-1-78743-150-8

Keywords

Open Access
Article
Publication date: 23 January 2023

Floriana Fusco, Marta Marsilio and Chiara Guglielmetti

Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have…

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Abstract

Purpose

Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.

Design/methodology/approach

A structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.

Findings

This study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.

Research limitations/implications

This study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.

Practical implications

The framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.

Originality/value

This is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.

Details

Journal of Service Management, vol. 34 no. 6
Type: Research Article
ISSN: 1757-5818

Keywords

Article
Publication date: 9 March 2015

Ritu Narang, Pia Polsa, Alabi Soneye and Wei Fuxiang

Healthcare service quality studies primarily examine the relationships between patients ' perceived quality and satisfaction with healthcare services, clinical…

Abstract

Purpose

Healthcare service quality studies primarily examine the relationships between patients ' perceived quality and satisfaction with healthcare services, clinical effectiveness, service use, recommendations and value for money. These studies suggest that patient-independent quality dimensions (structure, process and outcome) are antecedents to quality. The purpose of this paper is to propose an alternative by looking at the relationship between hospital atmosphere and healthcare quality with perceived outcome.

Design/methodology/approach

Data were collected from Finland, India, Nigeria and the People ' s Republic of China. Regression analysis used perceived outcome as the dependent variable and atmosphere and healthcare service quality as independent variables.

Findings

Results showed that atmosphere and healthcare service quality have a statistically significant relationship with patient perceived outcomes.

Research limitations/implications

The sample size was small and the sampling units were selected on convenience; thus, caution must be exercised in generalizing the findings.

Practical implications

The study determined that service quality and atmosphere are considered significant for developing and developed nations. This result could have significant implications for policy makers and service providers developing healthcare quality and hospital atmosphere.

Originality/value

Studies concentrate on healthcare outcome primarily regarding population health status, mortality, morbidity, customer satisfaction, loyalty, quality of life, customer behavior and consumption. However, the study exposes how patients perceive their health after treatment. Furthermore, the authors develop the healthcare service literature by considering atmosphere and perceived outcome.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 21 August 2017

Wafa Hammedi, Thomas Leclerq and Allard C.R. Van Riel

Gamification introduces game-like properties into routine service processes to make them more engaging for service employees and users alike. The purpose of this paper is to…

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Abstract

Purpose

Gamification introduces game-like properties into routine service processes to make them more engaging for service employees and users alike. The purpose of this paper is to investigate the effects of gamification mechanics, or game design principles, on user engagement in gamified healthcare services.

Design/methodology/approach

Through observations, interviews and the study of desk materials, two cases of gamified healthcare services, each using different game mechanics, are analyzed.

Findings

Gamification mechanics produce four distinct experiential outcomes in patients: challenge, entertainment, social dynamics, and escapism. Patient engagement can be stimulated through these outcomes. However, to fully enjoy the benefits of gamified services, users are often expected to acquire and use new skills. The relative absence of these skills (or difficulties in acquiring them), depending on users’ medical predispositions and age, may defer or negatively moderate the positive effects of gamification on engagement. In the case of progressively decreasing capabilities (e.g. in the case of aging users or users with degenerative diseases, whose physical or mental disabilities may be emphasized by the mechanics), it is recommended that health professionals adapt the mechanics accordingly or search for alternative options to increase patient well-being.

Research limitations/implications

The study was conducted in healthcare, and caution must be exercised in generalizing the findings to other domains. However, the finding that gamified service users’ disabilities - or the lack of required abilities – may negatively impact the encouraging or engaging effects of the use of gamification appears to be relatively universal.

Originality/value

This study contributes to service research, specifically in the healthcare domain, by providing insight into employees’ and users’ motivations for using gamified service processes, the experiential impact of gamification mechanics, the individual factors that influence users’ gamified experience and multiple forms of cognitive, emotional and behavioral engagement outcomes. A research agenda is developed.

Details

Journal of Service Management, vol. 28 no. 4
Type: Research Article
ISSN: 1757-5818

Keywords

Article
Publication date: 8 December 2023

Micaela Pinho, Pedro Ferreira and Sofia Gomes

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…

Abstract

Purpose

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).

Design/methodology/approach

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.

Findings

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).

Practical implications

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.

Originality/value

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.

Details

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

Keywords

Article
Publication date: 30 December 2021

Shahidul Islam, Nazlida Muhamad and Vai Shiem Leong

Transformative service research (TSR) has received considerable attention from researchers and marketers in recent years and becomes a research priority in health care. In…

Abstract

Purpose

Transformative service research (TSR) has received considerable attention from researchers and marketers in recent years and becomes a research priority in health care. In response, this paper adapts the TSR entities and wellbeing framework to systematically review healthcare quality research on Muslim consumers. The purpose of this paper is to identify research gaps and provide directions for future research, aligning healthcare studies with the TSR framework.

Design/methodology/approach

The authors of this paper reviewed empirical papers in healthcare quality research on Muslim patients between the years 2000 and 2020. The recorded journal articles were synthesized using insights from the TSR framework. Several literature gaps were identified and future research directions were provided using the TCCM framework, in which T stands for theory, C for context, C for characteristics and M for methodology.

Findings

This paper finds studies that encompass several domains of the TSR framework including cultural and religious dimensions, service interaction and customer engagement dimensions and customer service wellbeing. Findings also reveal subject matters related to the TSR framework, which receive less attention in the healthcare literature. A number of potential avenues for theoretical extension in health care are also discussed.

Social implications

The implications of this paper are highly relevant to Muslim healthcare consumers, the healthcare system and society in general. The findings suggest inspiring changes in the healthcare ecosystem that yields a greater quality of life (health and wellbeing) for individuals and their respective communities.

Originality/value

This paper advances the current state of healthcare research by identifying and organizing components of TSR entities and wellbeing framework, using Muslim patients as the context. It enhances some pioneering approaches within the domain of TSR and quality dynamics and provides a holistic perspective as guidance and systematic thinking to further advancement in the field of services marketing and Islamic marketing.

Details

Journal of Islamic Marketing, vol. 14 no. 3
Type: Research Article
ISSN: 1759-0833

Keywords

Article
Publication date: 7 March 2016

Amanda Shantz, Kerstin Alfes and Lilith Whiley

Due to increasing cost pressures, and the necessity to ensure high quality patient care while maintaining a safe environment for patients and staff, interest in the capacity for…

5343

Abstract

Purpose

Due to increasing cost pressures, and the necessity to ensure high quality patient care while maintaining a safe environment for patients and staff, interest in the capacity for HRM practices to make a difference has piqued the attention of healthcare professionals. The purpose of this papers is to present and test a model whereby engagement mediates the relationship between four HRM practices and quality of care and safety in two different occupational groups in healthcare, namely, nurses and administrative support workers.

Design/methodology/approach

Structural equation modeling was used to analyze questionnaire data collected by the National Health Service in the UK as part of their 2011 Staff Survey (n=69,018). The authors tested the hypotheses for nurses and administrative support workers separately.

Findings

Training, participation in decision making, opportunities for development, and communication were positively related to quality of care and safety via work engagement. The strength of the relationships was conditional on whether an employee was a nurse or administrative support worker.

Originality/value

This is the first paper to examine the mediating role of engagement on the relationship between four relevant HRM practices in the healthcare context, and outcomes important to healthcare practitioners. The authors also add value to the HRM literature by being among the first to use the job demands resources model to explain the impact of HRM practices on performance outcomes. Moreover, the authors provide insight into how HRM practices affect outcomes in the world’s largest publicly funded healthcare service.

Details

Personnel Review, vol. 45 no. 2
Type: Research Article
ISSN: 0048-3486

Keywords

Article
Publication date: 2 October 2020

Nina S. Pflugfelder

The purpose of this study is to investigate how Knowledge Management (KM) and Intellectual Capital (IC) can increase the organizational performance of ambulatory healthcare

Abstract

Purpose

The purpose of this study is to investigate how Knowledge Management (KM) and Intellectual Capital (IC) can increase the organizational performance of ambulatory healthcare providers and how such performance can be assessed.

Design/methodology/approach

Following the PRISMA guidelines, a structured review of peer-reviewed English-speaking articles up to 31st December 2019 was conducted. A search of ACM Digital Library, Cochrane Library, DARE, EBSCOHost, Medline, ProQuest, PubMed, ScienceDirect, Scopus and Web of Science produced 8,391 results. All studies that did not examine the impact of KM initiatives on organizational performance in an ambulatory healthcare provider setting were eliminated. The final sample of 31 studies was examined regarding the design of the KM initiatives as well as the performance concepts and indicators employed.

Findings

A range of KM tools and methods (Electronic Health Records, Clinical Decision Support, Health Information Technology, Training, Communities of Practice) have been shown to improve healthcare processes but evidence of an impact on outcomes remains mixed. Performance indicators focus on medical quality but rarely capture economic or social performance. Indicators have been adapted from the medical field, but do not adequately capture IC and KM-induced performance.

Originality/value

This review provides an overview of KM initiatives in ambulatory healthcare and assesses the associated performance metrics through an IC lens. Thereby, it enables further research on the interplay of IC, KM and performance in ambulatory care and points to several research gaps. It provides managers with guidance for designing KM initiatives in their organizations

Details

Journal of Intellectual Capital, vol. 22 no. 2
Type: Research Article
ISSN: 1469-1930

Keywords

Book part
Publication date: 22 February 2010

Rebecca K. Givan, Ariel Avgar and Mingwei Liu

This paper examines the relationship between human resource practices in 173 hospitals in the United Kingdom and four organizational outcome categories – clinical, financial…

Abstract

This paper examines the relationship between human resource practices in 173 hospitals in the United Kingdom and four organizational outcome categories – clinical, financial, employee attitudes and perceptions, and patient attitudes and perceptions. The overarching proposition set forth and examined in this paper is that human resource management (HRM) practices and delivery of care practices have varied effects on each of these outcomes. More specifically, the authors set forth the proposition that specific practices will have positive effects on one outcome category while simultaneously having a negative effect on other performance outcomes, broadly defined.

The paper introduces a broader stakeholder framework for assessing the HR–performance relationship in the healthcare setting. This multi-dimensional framework incorporates the effects of human resource practices on customers (patients), management, and frontline staff and can also be applied to other sectors such as manufacturing. This approach acknowledges the potential for incompatibilities between stakeholder performance objectives. In the healthcare industry specifically, our framework broadens the notion of performance.

Overall, our results provide support for the proposition that different stakeholders will be affected differently by the use of managerial practices. We believe that the findings reported in this paper highlight the importance of examining multiple stakeholder outcomes associated with managerial practices and the need to identify the inherent trade-offs associated with their adoption.

Details

Advances in Industrial and Labor Relations
Type: Book
ISBN: 978-1-84950-932-9

Book part
Publication date: 12 August 2014

Susan Albers Mohrman and Michael Kanter

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the knowledge…

Abstract

Purpose

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the knowledge management literature and network theory. The criticality of this issue to the establishment of sustainable healthcare relates to the lynchpin nature of embedding evidence-based knowledge in healthcare practice and the simultaneous challenge of combining this with clinical knowledge that derives from practice.

Methodology/approach

The case study is compiled from longitudinal interviews with over 40 physicians and other stakeholders and an examination of archival information including published articles generated by the learning system.

Findings

The socio-technical approach to building this learning system was critical given the expectations of physicians for autonomy in making clinical decisions with respect to their patients. This robust learning system builds on rich professional and organizational networks, is led by physicians, and builds on and extends the foundation of evidence relating to quality and value. The goals of the physician practice and a robust measurement and feedback system provide focus for the learning system.

Social/practical implications

Accelerating the incorporation of evidence-based practice and increasing the scope and reach of the learning system entails building physician networks, having a robust system for critically examining and extending evidence, and a clear linkage to valued outcomes.

Originality/value of paper

This detailed examination of the dynamics of knowledge absorption extends understanding of the capacity of medical care systems to absorb evidence-based knowledge.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
ISBN: 978-1-78441-035-3

Keywords

1 – 10 of over 28000