Search results

1 – 10 of over 26000
Article
Publication date: 14 April 2014

Robert Salvino, Michael Tasto and Gregory Randolph

– The purpose of this paper is to examine the long-run impact of federal government healthcare subsidies on the level of entrepreneurship as measured by self-employment.

Abstract

Purpose

The purpose of this paper is to examine the long-run impact of federal government healthcare subsidies on the level of entrepreneurship as measured by self-employment.

Design/methodology/approach

Using annual healthcare and employment data from 1948 through 1999, the paper empirically examines the relationship between the growth in employer-provided healthcare and the rate of self-employment as a share of the non-agriculture, civilian labor force.

Findings

The regression results imply that there is a consistent effect that has appeared over time – where federal healthcare subsidies have disproportionately benefitted larger firms, contributing to the decline in the rate of self-employment, within-firm innovation, and factor mobility over time.

Research limitations/implications

The research in this study is limited by the examination of self-employment only and a constant institutional structure across all states, only varying across time for the entire USA. In addition, an empirical study looking at how the value of healthcare benefits have changed over time – vs the sole question in this study that depends upon whether or not an individual is covered or not would be very useful in determining the true effect on an entrepreneur.

Social implications

Reducing or removing the layers of healthcare subsidies would bring about an increase in the transparency of the wage-productivity relationship and a more efficient allocation of labor and entrepreneurial ability across firm sizes.

Originality/value

This paper presents empirical evidence supporting specific improvements to national healthcare policy at a time when such policy is undergoing significant change with consequences for entrepreneurial decision making.

Details

Journal of Entrepreneurship and Public Policy, vol. 3 no. 1
Type: Research Article
ISSN: 2045-2101

Keywords

Article
Publication date: 8 January 2020

Ajantha Sisira Kumara and Ramanie Samaratunge

The purpose of this paper is to explore the determinants of health insurance ownership of individuals in the Sri Lankan labor force and to examine how insurance ownership…

Abstract

Purpose

The purpose of this paper is to explore the determinants of health insurance ownership of individuals in the Sri Lankan labor force and to examine how insurance ownership impacts healthcare utilization.

Design/methodology/approach

The authors first used logit model to explore determinants of health insurance ownership. The authors then employed propensity score matching method to estimate impact of insurance ownership on healthcare utilization. Data were obtained from national survey of self-reported health in Sri Lanka – 2014 (n=59,276). National survey of self-reported health in Sri Lanka – 2014 was conducted by the Department of Census and Statistics from January to December 2014.

Findings

Results showed that individuals with higher educational attainments, headed by literate-heads, based in urban sector, employed in formal sector, and with health adversities and higher degree of risk propensity are more inclined to have a health cover. Health insurance ownership reduces the likelihood of utilizing public facilities while increasing the likelihood of utilizing private facilities for non-communicable diseases (NCDs) and acute illnesses. Welfare consequences of expanding insurance ownership are doubtful due to oligopolistic private healthcare market and adverse selection issue faced by insurers in Sri Lanka.

Originality/value

This is the first study examining health insurance–healthcare utilization nexus based on Sri Lanka-wide microdata. Also, the study applies bias-corrected matching methods to establish causal links between two constructs. Without being so generalized, healthcare utilization is examined in terms of NCD care and Acute illnesses care, which improves robustness of results and leads to evidence-based healthcare policies.

Peer review

The peer review history for this paper is available at: https//publons.com/publon/10.1108/IJSE-05-2019-0333.

Details

International Journal of Social Economics, vol. 47 no. 2
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 16 May 2016

Ross Millar, Weiyan Jian, Russell Mannion and Robin Miller

The purpose of this paper is to explore recent healthcare reform in China. Reflecting on the current literature, the viewpoint argues that greater attention should be paid…

1139

Abstract

Purpose

The purpose of this paper is to explore recent healthcare reform in China. Reflecting on the current literature, the viewpoint argues that greater attention should be paid to healthcare reform in China as a public policy process, particularly one that is built on policy experimentation.

Design/methodology/approach

The viewpoint argues that while recent efforts to understand the impact of reform have brought significant understanding of key issues and processes, such interest tends to focus on pragmatic concerns rather than pose wider theoretical and methodological questions about the nature and pace of reform.

Findings

The authors suggest that the lens of public policy is particular relevant and insightful given what has been documented elsewhere regarding China’s unique policy process characterised by “policy experimentation”. The authors discuss how a policy experiment perspective can provide a useful heuristic for understanding healthcare reform in China.

Originality/value

The viewpoint concludes by outlining possible applications of this approach and looks forward at the emerging research agenda in this area.

Details

Journal of Health Organization and Management, vol. 30 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Book part
Publication date: 22 March 2021

Sophie Guthmuller, Paolo Paruolo and Stefano Verzillo

This chapter summarises the role of EU actions in supporting healthcare policies in the EU Member States, both looking at implemented actions and describing current…

Abstract

This chapter summarises the role of EU actions in supporting healthcare policies in the EU Member States, both looking at implemented actions and describing current priorities for the future. It argues that these coordinated actions can be beneficial for EU Member States by helping them to avoid duplication of effort and to attain economies of scale. Moreover, data sharing with proper safeguards can unleash vast amount of ‘learning what works’ both for medical treatments and for healthcare sustainability measures. The need for this common learning appears ever more urgent while facing the health and economic consequences of the present pandemic.

Details

The Sustainability of Health Care Systems in Europe
Type: Book
ISBN: 978-1-83909-499-6

Keywords

Article
Publication date: 14 June 2011

Sameer Kumar, Neha S. Ghildayal and Ronak N. Shah

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…

10401

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Practical implications

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.

Originality/value

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.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 16 August 2019

Terrylyna Baffoe-Bonnie, Samuel Kojo Ntow, Kwasi Awuah-Werekoh and Augustine Adomah-Afari

The purpose of this paper is to explore the influence of health system factors on access to a quality healthcare among prisoners in Ghana.

Abstract

Purpose

The purpose of this paper is to explore the influence of health system factors on access to a quality healthcare among prisoners in Ghana.

Design/methodology/approach

Data were gathered using different qualitative methods (interviews and participant observation) with staff of the James Camp Prison, Accra. Findings were analyzed using a framework method for the thematic analysis of the semi-structured interview data; and interpreted with the theoretical perspective of health systems thinking and innovation.

Findings

The study concludes that health system factors such as inadequate funding for health services, lack of skilled personnel and a paucity of essential medical supplies and drugs negatively affected the quality of healthcare provided to inmates.

Research limitations/implications

The limited facilities available and the sample size (healthcare workers and prison administrators) impeded the achievement of varied views on the topic.

Practical implications

The paper recommends the need for health policy makers and authorities of the Ghana Prison Service to collaborate and coordinate in a unified way to undertake policy analysis in an effort to reform the prisons healthcare system.

Social implications

The national health insurance scheme was found to be the financing option for prisoners’ access to free healthcare with supplementation from the Ghana Prison Service. The study recommends that policy makers and healthcare stakeholders should understand and appreciate the reality that the provision of a quality healthcare for prisoners is part of the entire system of healthcare service delivery in Ghana and as such should be given the needed attention.

Originality/value

This is one of few studies conducted on male only prisoners/prison in the context of Ghana. It recommends the need for an integrated approach to ensure that the entire healthcare system achieves set objectives in response to the primary healthcare concept.

Details

International Journal of Prisoner Health, vol. 15 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 14 November 2019

Andrea Frankowski

The purpose of this paper is to examine the enactment of collaborative governance as a policy strategy in healthcare – in particular its effects in coordinating multiple…

Abstract

Purpose

The purpose of this paper is to examine the enactment of collaborative governance as a policy strategy in healthcare – in particular its effects in coordinating multiple collaborative initiatives dedicated to improve the performance of health organizations. It studies overarching governance mechanisms that serve as platforms at a meta-level between policy and frontline practice.

Design/methodology/approach

Four collaborative governance arrangements dedicated to improve health outcomes in the Netherlands are analyzed in a comparative case-study design, based on extensive document analysis (n=121) and interviews (n=56) with key stakeholders in the field, including the Dutch Ministry of Health, health organizations and other actors.

Findings

The studied policy-based governance mechanisms for the coordination of multiple micro-level collaborative initiatives function partly as platforms in bringing actors and resources together successfully. They do so, by fostering evolvability (the capacity to generate diversity in emergent ways) in relation to goal-setting and intermediation between actors. Yet, they marginalize open access to participants through high selectivity and deliberate exclusion strategies for certain actors, contrary to a platform logic of action.

Research limitations/implications

While the collaborative governance literature focuses on these dimensions as independent elements, findings reveal both trade-offs and interdependencies between studied dimensions of coordination associated with platforms, that need to be negotiated and managed.

Practical implications

Selectivity and exclusion in collaborative arrangements may negatively affect relational bonds and ties between actors, which challenges the application of collaborative governance as a policy strategy in pursuit of health objectives.

Originality/value

Responding to recent calls in the literature, this study applies ideas from public administration to the field of health organization and management to avert failures in the translation of policy ambitions into health practice.

Details

Journal of Health Organization and Management, vol. 33 no. 7/8
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 16 November 2020

Elisabeth Dahlborg, Ellinor Tengelin, Elin Aasen, Jeanne Strunck, Åse Boman, Aase Marie Ottesen, Berit Misund Dahl, Lindis Kathrine Helberget and Inger Lassen

The paper aims to compare and discuss the findings of discursive constructions of patients in legal texts from the three Scandinavian countries. Since traditional welfare…

Abstract

Purpose

The paper aims to compare and discuss the findings of discursive constructions of patients in legal texts from the three Scandinavian countries. Since traditional welfare state systems in Scandinavia are being challenged by new governance systems, new questions are being raised about patient positions and agency, carrying with them potential ethical dilemmas for healthcare professionals.

Design/methodology/approach

The methodology of the paper is inspired by critical discourse analysis. Comprehensively analysing the findings of previous discourse studies on how “the patient” is constructed in central policy texts, this study compares the position of the patient in Norway, Sweden and Denmark.

Findings

The paper reveals ideological struggles across the Scandinavian countries, operating at a political level, a legislative level and a healthcare level. It is shown that national governance systems still exert hegemonic power by strongly influencing patients' degree of choice and autonomy. The discursive struggle between welfare state governance and other governance systems in Scandinavia indicates a shift towards a commercial healthcare market although a traditional welfare model is advocated by professionals and researchers.

Research limitations/implications

Because of the specific conditions of Scandinavian healthcare policy, the findings lack generalisability. The research approach should therefore be explored further in additional contexts.

Practical implications

The findings of this study can inform policymakers, professionals and patients of the ideological values underlying seemingly objective shifts in national policy.

Originality/value

A comparative critical discourse analysis can expose patterns in the Scandinavian approaches to patient rights.

Details

International Journal of Health Governance, vol. 26 no. 1
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 20 June 2016

Joyce Bierbooms, Hans Van Oers, Jeroen Rijkers and Inge Bongers

Stakeholder management is not yet incorporated into the standard practice of most healthcare providers. The purpose of this paper is to assess the applicability of a…

Abstract

Purpose

Stakeholder management is not yet incorporated into the standard practice of most healthcare providers. The purpose of this paper is to assess the applicability of a comprehensive model for stakeholder management in mental healthcare organization for more evidence-based (stakeholder) management.

Design/methodology/approach

The assessment was performed in two research parts: the steps described in the model were executed in a single case study at a mental healthcare organization in the Netherlands; and a process and effect evaluation was done to find the supporting and impeding factors with regard to the applicability of the model. Interviews were held with managers and directors to evaluate the effectiveness of the model with a view to stakeholder management.

Findings

The stakeholder analysis resulted in the identification of eight stakeholder groups. Different expectations were identified for each of these groups. The analysis on performance gaps revealed that stakeholders generally find the collaboration with a mental healthcare provider “sufficient.” Finally a prioritization showed that five stakeholder groups were seen as “definite” stakeholders by the organization.

Practical implications

The assessment of the model showed that it generated useful knowledge for more evidence-based (stakeholder) management. Adaptation of the model is needed to increase its feasibility in practice.

Originality/value

Provided that the model is properly adapted for the specific field, the analysis can provide more knowledge on stakeholders and can help integrate stakeholder management as a comprehensive process in policy planning.

Details

Journal of Health Organization and Management, vol. 30 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 21 November 2016

Krista Lyn Harrison and Holly A. Taylor

Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health…

1177

Abstract

Purpose

Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions.

Design/methodology/approach

The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders.

Findings

Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies. Organizational values of access to care and stewardship most frequently affected resource allocation and policy decisions, while economic and political pressures affect the relative prioritization of values.

Research limitations/implications

Small sample size, the potential for social desirability or recall bias, and the exclusion of provider, member or community perspectives beyond those represented among participating board members.

Practical implications

Program directors or researchers can use this study to assess the extent to which resource allocation and policy decisions align with organizational values and mission statements.

Social implications

The description of how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions.

Originality/value

This study addresses a gap in literature regarding how CAPs actually make resource allocation decisions that affect access to healthcare services.

Details

Journal of Health Organization and Management, vol. 30 no. 8
Type: Research Article
ISSN: 1477-7266

Keywords

1 – 10 of over 26000