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Article
Publication date: 14 December 2021

Muhammad Jufri Marzuki and Graeme Newell

As the prolonged effect of the COVID-19 pandemic has materially impacted investment returns significantly, it is more crucial than ever for institutional investors to…

Abstract

Purpose

As the prolonged effect of the COVID-19 pandemic has materially impacted investment returns significantly, it is more crucial than ever for institutional investors to redefine their property portfolios using assets with better investment management potential and meaningful diversification benefits. The “alternative asset revolution” is gaining traction in the property investment space internationally among institutional investors due to the shifting investment attitudes towards the alternative property sectors. Australia's $205bn healthcare property sector is at the forefront of this revolution due to its societal significance, as well as its attractive investment qualities. This paper investigates the institutional investor management of the Australian healthcare property sector via both the direct and listed channels and empirically analyses its investment attributes.

Design/methodology/approach

Using the unique Morgan Stanley Capital International/Property Council of Australia quarterly data set for Australian direct healthcare property over 2006–2020, the risk-adjusted performance and portfolio diversification potential direct healthcare property and listed healthcare were assessed. A constrained mean-variance portfolio optimisation framework was used to develop a six-asset portfolio scenario to analyse the portfolio added-value benefits of both direct healthcare property and listed healthcare in a mixed-asset investment strategy. A similar set of analysis was performed using the post-global financial crisis (GFC) quarterly time series of 2009–2020 to investigate the healthcare asset class' performance dynamics in the post-GFC investment timeframe.

Findings

The results indicate that direct healthcare property and listed healthcare offer two key advantages for institutional investors in managing their property portfolios: (1) a stable yet superior risk-adjusted performance and (2) significant portfolio diversification potential in managing their property portfolios. Importantly, both direct healthcare property and listed healthcare provided valuable contributions in strengthening an investment portfolio's performance. The post-GFC sub-period analysis revealed a consistent conclusion regarding the healthcare asset class's performance attributes.

Originality/value

This is the first research that provides an independent empirical examination of the strategic importance of Australian healthcare property as a maturing alternative property sector that can serve both investment and environmental, social and governance goals of investors. This research presents a positive investment prognosis for the Australian healthcare property sector to achieve its institutionalised status as a mainstream asset class of the future.

Article
Publication date: 18 November 2021

Timotej Jagric, Stefan Otto Grbenic and Vita Jagric

With high public debts and suffering economies after the COVID-19 pandemic, governments will look for ways to promote recovery. Literature substantially reports on the…

Abstract

Purpose

With high public debts and suffering economies after the COVID-19 pandemic, governments will look for ways to promote recovery. Literature substantially reports on the favorable macroeconomic impact of the healthcare sector.

Design/methodology/approach

The authors use data on 19 European countries. Over 30 variables are analyzed to find factors that foster or suppress the economic impact of the healthcare sector. The economic impact is thereby expressed through five types of total multipliers, acting as dependent variables. The authors estimate multiple econometric models.

Findings

The results indicate factors that intensify or reduce the economic impact of the healthcare sector as they cause the value of one or more economic multipliers to augment or to diminish. Positive effects are expected from the growth of public funds' share in total healthcare expenditure leading to a higher output, income and value-added multipliers. The import multiplier diminishes when expenditure on healthcare as percent of GDP rises. On the other hand, rising expenditure on pharmaceuticals in the share of healthcare expenditure lowers the output multiplier. Rising GDP per capita and higher healthcare systems' technical efficiency cause the employment multiplier to lower.

Originality/value

Policymakers can strengthen the economic impact of the healthcare sector on the national economy. This could be achieved by stimulating factors, being identified in our study. Strengthening the economic impact of the healthcare sector is especially welcomed when fostering economic recovery is needed.

Details

International Journal of Health Governance, vol. 27 no. 1
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 16 August 2021

Svitlana Tsymbaliuk and Tetiana Shkoda

High European standards of life quality are declared in a set of legislative documents in Ukraine, but the rewarding policy for the healthcare employees because of the…

Abstract

Purpose

High European standards of life quality are declared in a set of legislative documents in Ukraine, but the rewarding policy for the healthcare employees because of the coronavirus disease 2019 (COVID-19) disease remains not fully implemented. The purpose of the study is to develop indicators, standards and methods of assessing rewarding policies for healthcare employees in terms of providing decent labour remuneration that are useful for all stakeholders of the healthcare sector in Ukraine.

Design/methodology/approach

The study proposes the methodical foundations of developing evaluation tools of rewarding policies for implementing the decent work concept at the sectoral level.

Findings

The findings identify the complex indicator of decent labour remuneration in the healthcare sector in Ukraine, which is 0.185. It proves that the level of the decent labour remuneration of the healthcare employees in Ukraine is at the low level.

Practical implications

The study provides the important recommendations for all policymakers in the healthcare sector in different countries in the context of diagnosing the problems in the rewarding policies and determining the directions for improvement in terms of implementation of the decent work principles.

Originality/value

By proposing and calculating the main methodical foundations of evaluation tools development of rewarding policies in the context of realisation of the decent work concept at the sectoral level, the study fills a void in the decent labour remuneration and the labour economics theory literature.

Details

Employee Relations: The International Journal, vol. 44 no. 1
Type: Research Article
ISSN: 0142-5455

Keywords

Article
Publication date: 9 July 2018

Saad Ahmed Javed and Fatima Ilyas

The purpose of this paper is to assess the influence of patients’ expectations from healthcare service quality on their satisfaction with nursing in public and private…

1332

Abstract

Purpose

The purpose of this paper is to assess the influence of patients’ expectations from healthcare service quality on their satisfaction with nursing in public and private hospitals of Pakistan.

Design/methodology/approach

Data (n=456) were collected from three public sector hospitals and three private sector hospitals of Lahore, the capital of Pakistan’s most populous province. Male and female patients who have experience of both sectors were surveyed using a self-administered questionnaire developed using the original SERVQUAL approach. Data were analyzed using the statistical techniques and the Laplace criterion.

Findings

This paper attempts to explain degree of influences of five service quality constructs (empathy, responsiveness, tangibility, reliability and assurance) on Pakistani patients’ expectations from the private and public sector hospitals and thus patient satisfaction. Further, this work can offer several intuitions into the effect of five constructs of service quality on patients’ expectations of healthcare service quality and patient satisfaction with the service providers/nursing. The results reveal that the patient satisfaction is most strongly related to empathy in public sector and to responsiveness in private sector.

Research limitations/implications

In light of the previous studies and the current research findings, the study anticipates no apparently significant improvement in healthcare sector of Pakistan in near future considering various factors discussed in the study. The study will also help the service providers and the policy makers in understanding the deteriorating situation of the Pakistani healthcare sector and will guide them in identifying the areas by improving which not only the healthcare service quality in the country can be improved but also the image of healthcare sector among the masses and competitiveness of the healthcare sector can be enhanced.

Originality/value

The value of the study rests in its critical analysis of the current status of the healthcare sector of Pakistan with a view to suggest the areas that need to be worked on by the service providers and policy makers. Also, the study tries to settle a controversy within Pakistani healthcare literature concerning the question that who is producing more satisfied patients: private hospitals or their public counterparts?

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 17 July 2018

Graeme Newell and Muhammad Jufri Marzuki

Amongst the alternate property sectors, healthcare property has recently become an important property sector for major investors such as pension funds in the global…

Abstract

Purpose

Amongst the alternate property sectors, healthcare property has recently become an important property sector for major investors such as pension funds in the global property landscape; particularly in the UK, and being driven by the ageing population demographics. The purpose of this paper is to assess the significance, risk-adjusted performance and portfolio diversification benefits of UK healthcare property in a UK property and mixed-asset portfolio over 2007–2016. Both healthcare property and listed healthcare property channels are assessed. Drivers and risk factors for the on-going development of the healthcare property sector are also identified.

Design/methodology/approach

Using annual total returns, the risk-adjusted performance and portfolio diversification benefits of UK healthcare property over 2007–2016 is assessed. An asset allocation diagram is used to assess the role of both healthcare property channels in a UK property portfolio and in a UK mixed-asset portfolio.

Findings

Both UK healthcare property and listed healthcare property delivered superior risk-adjusted returns compared to UK property, stocks and listed property over 2007–2016, with portfolio diversification benefits in the fuller mixed-asset portfolio context, but not in a narrower property portfolio context. Importantly, this sees both UK healthcare property channels as strongly contributing to the UK property and mixed-asset portfolios across the entire portfolio risk spectrum and validating the property industry perspective of healthcare property being low risk and providing diversification benefits in a mixed-asset portfolio. However, this was not to the loss or substitution of traditional direct property exposure.

Practical implications

Healthcare property is an alternate property sector that has become increasingly important in recent years. The results highlight the important role of both healthcare property channels in a UK property portfolio and in a UK mixed-asset portfolio. The strong risk-adjusted performance of both UK healthcare property compared to UK property, stocks and listed property sees both UK healthcare property channels contributing to the mixed-asset portfolio across the entire portfolio risk spectrum. This is particularly important, as many investors (e.g. pension funds) now see healthcare property as an important property sector in their overall portfolio; particularly with the ageing population dynamics in most countries. The importance of both healthcare property channels sees healthcare property exposure accessible to both small investors and large investors.

Originality/value

This paper is the first published empirical research analysis of the risk-adjusted performance of UK healthcare property, and the role of healthcare property in a UK property portfolio and in a UK mixed-asset portfolio. This research enables empirically validated, more informed and practical property investment decision-making regarding the strategic role of both healthcare property and listed healthcare property in a portfolio.

Details

Journal of Property Investment & Finance, vol. 36 no. 5
Type: Research Article
ISSN: 1463-578X

Keywords

Article
Publication date: 11 February 2019

Redwanur Rahman

The purpose of this paper is to examine the factors that triggered the privatisation of Bangladesh’s health sector.

Abstract

Purpose

The purpose of this paper is to examine the factors that triggered the privatisation of Bangladesh’s health sector.

Design/methodology/approach

This study follows systematic reviews in its undertaking and is based on an extensive review of both published and unpublished documents. Different search engines and databases were used to collect the materials. The study takes into account of various research publications, journal articles, government reports, policy and planning documents, relevant press reports/articles, and reports and discussion papers from the World Health Organization, the World Bank and the Asian Development Bank.

Findings

While Bangladesh’s healthcare sector has undergone an increasing trend towards privatisation, this move has limited benefits on the overall improvement in the health of the people of Bangladesh. The public sector should remain vital, and the government must remobilise it to provide better provision of healthcare.

Research limitations/implications

The paper focusses only on the public policy aspect of privatisation in healthcare of a country.

Practical implications

The paper examines the issue of privatisation of healthcare and concludes that privatisation not only makes services more expensive, but also diminishes equity and accountability in the provision of services. The study, first, makes a spate of observations on improving public healthcare resources, which can be of value to key decision makers and stakeholders in the healthcare sector. It also discourages the move towards private sector interventions.

Originality/value

This study is an independent explanation of a country’s healthcare system. Lesson learned from this study could also be used for developing public policy in similar socio-economic contexts.

Details

International Journal of Health Care Quality Assurance, vol. 32 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Book part
Publication date: 16 January 2023

Nkemdilim Iheanachor, Oluseye Jegede and Emma Etim

Nigeria remains the largest economy in Africa. However, its health sector is described as weak. It continues to battle several challenges ranging from poor health…

Abstract

Nigeria remains the largest economy in Africa. However, its health sector is described as weak. It continues to battle several challenges ranging from poor health infrastructure, inaccessibility of good quality health care, corruption, substandard drugs circulating, poor funding, shortage of healthcare personnel, high cost of healthcare amidst poverty-stricken masses, among others. The outbreak of Covid-19 and the global oil price crash have further impacted Nigeria’s dwindling healthcare service delivery/indicators. This chapter thus takes stock of the status of the healthcare indicators, healthcare systems, and healthcare governance in Nigeria before and during the Covid-19 pandemic to decipher the impact of the damage caused by Covid-19 on the already weak Nigeria’s health sector. It discusses healthcare indicators, system constraints and responses, and the demand and supply of health care in Nigeria in the era of Covid-19. This chapter shows how Covid-19 has negatively and positively affected the healthcare sector in Nigeria. However, the negative impact remains overwhelming and has potentially grave consequences. This study thus develops a policy framework and time-tested strategy to recover Nigeria’s health sector while factoring in the present capabilities of Nigeria’s health sector. This study thus recommends that adequate infrastructure investment and welfare for healthcare workers are important for the recovery of Nigeria’s health sector.

Details

Responsible Management of Shifts in Work Modes – Values for Post Pandemic Sustainability, Volume 2
Type: Book
ISBN: 978-1-80262-723-7

Keywords

Article
Publication date: 7 August 2018

Saad Ahmed Javed and Sifeng Liu

The purpose of this paper is to analyse the relationship between outpatient satisfaction and the five constructs of healthcare projects’ service quality in Pakistan using…

Abstract

Purpose

The purpose of this paper is to analyse the relationship between outpatient satisfaction and the five constructs of healthcare projects’ service quality in Pakistan using Deng’s grey incidence analysis (GIA) model, absolute degree GIA model (ADGIA), a novel second synthetic degree GIA (SSDGIA) model and two approaches of decision-making under uncertainty.

Design/methodology/approach

The study proposes a new synthetic GIA model and demonstrates its feasibility on data (N=221) collected from both public and private sector healthcare projects of Punjab, the most populous province of Pakistan, using a self-administered questionnaire developed using the original SERVQUAL approach.

Findings

The results of decision analysis approach indicated that outpatients’ satisfaction from the private sector healthcare projects is higher as compared to the public healthcare projects’. The results from the proposed model revealed that tangibility and reliability play an important role in shaping the patient satisfaction in the public and private sectors, respectively.

Originality/value

The study is pioneer in evaluating a healthcare system’s service quality using grey system theory. The study proposes the SSDGIA model as a novel method to evaluate parameters comprehensively based on their mutual association (given by absolute degree of grey incidence) and inter-dependencies (given by Deng’s degree of grey incidence), and tests the new model in the given scenario. The study is novel in terms of its analysis of data and modelling. The study also proposes a comprehensive structure of the healthcare delivery system of Pakistan.

Details

Grey Systems: Theory and Application, vol. 8 no. 4
Type: Research Article
ISSN: 2043-9377

Keywords

Article
Publication date: 1 December 2005

Akintola Akintoye and Ezekiel Chinyio

The UK Government has now adopted Private Finance Initiative (PFI) as a major vehicle for the delivery of additional resources to the health sector in order to achieve a…

4358

Abstract

Purpose

The UK Government has now adopted Private Finance Initiative (PFI) as a major vehicle for the delivery of additional resources to the health sector in order to achieve a greater investment in healthcare facilities. The purpose of this paper is to examine the trends and risk assessment of the PFI in the healthcare sector.

Design/methodology/approach

The paper employed secondary data and interviews of key participants in two hospital PFI projects to highlight developments in healthcare PFI and the risk management of hospital projects.

Findings

The results show that the use of PFI in the provision of healthcare is increasing in terms of number, capital value and size of projects. What emerged in the healthcare PFI project was a usage of a plethora of risk management techniques, albeit to varying degrees. Experience appeared to be the prime risk assessment technique employed, while risk avoidance was first explored before pricing and allocating any residual risks. “Risk prompts”, such as using checklists and risk registers were also useful in the identification of risks. Among all participants, insurance cover and sub‐contracting appear to be the most prominent strategies employed for managing out the risks.

Originality/value

The negotiations that precede the signing of a healthcare PFI project contract had an impact on the final choice of facilities or their specifications. The two contracting parties sought a balance between an optimal allocation of risks, choice of facilities and project price. Although the risk management techniques being used are generic in nature, there is still no evidence at the moment to show that these are appropriate for PFI projects. It is important that further investigation is undertaken to assess the level of current skills in risk management techniques to deal with PFI projects and the extent to which these techniques are appropriate to tackle complex healthcare PFI projects.

Details

Engineering, Construction and Architectural Management, vol. 12 no. 6
Type: Research Article
ISSN: 0969-9988

Keywords

Article
Publication date: 5 July 2013

Robert Eadie, Phillip Millar and Rory Grant

Public private partnerships (PPP) and the private finance initiative (PFI) are defined as a range of practical long‐standing relationships between the public and private…

1345

Abstract

Purpose

Public private partnerships (PPP) and the private finance initiative (PFI) are defined as a range of practical long‐standing relationships between the public and private sectors. This paper aims to investigate managers’ perceptions of PPP/PFI in two of the three largest sectors for private sector capital‐spend in PPP/PFI schemes, namely transport (highway infrastructure) and healthcare.

Design/methodology/approach

A web‐based Limesurvey™ questionnaire was used to collect data. A sample of 75 organisations was identified from the Partnerships UK (PUK) online Project Database (Partnerships UK, 2010). Total of 49 responses were received, of which 39 were complete.

Findings

Results from each sector relating to PPP/PFI “best value”, advantages and disadvantages, and government preferred procurement routes, are investigated. The majority of organisations did not consider that PPP/PFI provided “best value” but thought it provided more value than the other two UK Government preferred procurement routes, “design and build” and “prime contracting”.

Practical implications

This questions the UK Government's choice of preferred procurement routes. However, even during a recession and its aftermath, the majority of respondents consider that PPP/PFI remains appropriate to healthcare and transport developments.

Originality/value

Firstly, this paper carries out a ranking of common advantages and disadvantages to PFI/PPP followed by an investigation of “best value” as perceived by contractors and consultants subsequent to the construction phase. Then the three preferred UK Government procurement routes are contrasted in terms of “best value” and finally the paper investigates how PPP/PFI schemes are viewed during recessionary times.

Details

Built Environment Project and Asset Management, vol. 3 no. 1
Type: Research Article
ISSN: 2044-124X

Keywords

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