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1 – 10 of over 2000This paper aims to examine the factors that affect the quality of healthcare services in the implementation of the National Health Insurance Scheme (NHIS) at the local level in…
Abstract
Purpose
This paper aims to examine the factors that affect the quality of healthcare services in the implementation of the National Health Insurance Scheme (NHIS) at the local level in Ghana from the perspectives of health policy implementers and beneficiaries in public-private organisations.
Design/methodology/approach
This paper has adopted a mixed research method with both qualitative and quantitative data, with in-depth interviews, document analysis and focus groups discussions. A total of 107 participants took part in the interviews and the questionnaire survey.
Findings
The study found that these factors greatly affect the quality of healthcare services from the implementers’ perspectives — referrals, effectiveness in monitoring, timeliness, efficiency, reimbursement, compliance with standard guidelines of Ghana Health Service (GHS) and accreditation process. For the beneficiaries, three healthcare services factors are important, including medical consultations, diagnostic services and the supply of drugs and medicines. Some other factors are found to be the least prioritized healthcare services, namely the issuance of prescription forms, verification of identification (ID) cards and staff attitude. However, the study found that implementers and beneficiaries exhibited a mixed reaction (perspectives) on accessing some healthcare services. In some healthcare services where the implementers perceived that beneficiaries have more access to such services, the beneficiaries think otherwise, an irony in the perspectives of the two actors.
Originality/value
This paper adds to the extant literature on the perspectives of policy implementers and beneficiaries on factors that affect the quality of healthcare services in general and specifically on the implementation of NHIS in Ghana with the public-private dimension.
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Ajimon George and Jobin Sahadevan
This study aims to deal with the paucity of studies in the stages of the development of loyalty behaviour of customers in the healthcare context by incorporating three crucial…
Abstract
Purpose
This study aims to deal with the paucity of studies in the stages of the development of loyalty behaviour of customers in the healthcare context by incorporating three crucial service quality dimensions (physical environment, personnel quality and technical quality) and also investigating trust and commitment as mediating factors.
Design/methodology/approach
Survey data were obtained from 420 respondents admitted to government hospitals in Kerala employing a convenience sampling method. The formulated hypotheses were tested using partial least square structural equation modelling.
Findings
Results indicate that patient satisfaction, trust and commitment can create favourable behavioural intentions amongst patients. When patients reveal higher trust, they are more inclined to value healthcare services and willing to commit to a long-term relationship, resulting in increased patient loyalty.
Practical implications
Organisational efforts should improve trust and commitment and build a good relationship between service providers and patients. Efforts should be taken to raise the standard of technical and personnel aspects, and a focus on physical infrastructure should also be considered to build a favourable behavioural intention to revisit and positive referrals.
Originality/value
This is the first empirical study to analyse technical quality, personnel quality and physical environment along with the mediating effect of trust, and commitment in a four-stage loyalty development model in the healthcare context of Kerala, India.
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Yee-man Tsui and Ben Y.F. Fong
The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial…
Abstract
Purpose
The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.
Design/methodology/approach
The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.
Findings
The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.
Originality/value
The over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals.
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Yunwei Gai, Alia Crocker, Candida Brush and Wiljeana Jackson Glover
Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes…
Abstract
Purpose
Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.
Design/methodology/approach
Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.
Findings
Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.
Originality/value
This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.
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The purpose of this study was to review existing healthcare service quality-measurement models.
Abstract
Purpose
The purpose of this study was to review existing healthcare service quality-measurement models.
Design/methodology/approach
A review of the literature was conducted utilizing keywords “healthcare’’, “service quality’’, “measurement models”, “SERVQUAL”, “SERVPERF”, “HEALTHQUAL”, “PubHosQual” and “HospitalQual”. These investigations were selected from the “Emerald’’, “ABI/Inform”, “ScienceDirect” and “EBSCOhost” databases. A range of studies used in the makeup of the healthcare quality-measurement model for a 36 years period (1979 to 2015) were examined in an exhaustive survey of the literature. Of 137 studies reviewed, 74 studies were selected for analysis.
Findings
As yet, no consensus has been reached among scholars on the definition and indicators and factors of the quality of the healthcare services. Moreover, most of the current models are of Western origin and incongruent with the cultural and economic contexts of developing countries. The previous studies create scales resembling the generic measures of service quality, which may not be completely appropriate for assessing the perceived quality of healthcare services. Furthermore, previous studies were too narrow, overemphasizing the quality of healthcare only as far as the functional aspect of the services were concerned and paying too little attention to the technical aspects, using the experience of healthcare providers. These results have much room for failures. This is therefore advising healthcare organizations that need to develop their own models for measuring the quality of their services.
Originality/value
Generic models no longer suffice in measuring the quality of healthcare services. Developing countries should try and develop their own models for measuring the quality of healthcare services.
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Mushtaq Ahmad Darzi, Sheikh Basharul Islam, Syed Owais Khursheed and Suhail Ahmad Bhat
The purpose of this study is to summarize the available pool of literature on service quality to identify different dimensions of service quality in the healthcare industry and…
Abstract
Purpose
The purpose of this study is to summarize the available pool of literature on service quality to identify different dimensions of service quality in the healthcare industry and understand how it is measured. The study attempts to explore the research gaps in the literature about different service quality dimensions and patient satisfaction.
Design/methodology/approach
A systematic literature review process was followed to achieve the objectives of the study. Various inclusion and exclusion criteria were used to select relevant research articles from 2000–2020 for the study, and a total of 100 research articles were selected.
Findings
The study identified 41 different dimensions of healthcare service quality measurement and classified these dimensions into four categories, namely servicescape, personnel, hospital administration and patients. It can be concluded that SERVQUAL is the most widely used service quality measurement tool.
Originality/value
The study identified that a majority of the researchers deduced a positive relationship between SERVQUAL dimensions and the quality of healthcare services. The findings of study will assist hospital executives in formulating effective strategies to ensure that patients receive superior quality healthcare services.
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Alec Knight, Peter Littlejohns, Tara-Lynn Poole, Gillian Leng and Colin Drummond
The purpose of this paper is to explore factors affecting implementing the National Institute for Health and Care Excellence (NICE) quality standard on alcohol misuse (QS11) and…
Abstract
Purpose
The purpose of this paper is to explore factors affecting implementing the National Institute for Health and Care Excellence (NICE) quality standard on alcohol misuse (QS11) and barriers and facilitators to its implementation.
Design/methodology/approach
Qualitative interview study analysed using directed and conventional content analyses. Participants were 38 individuals with experience of commissioning, delivering or using alcohol healthcare services in Southwark, Lambeth and Lewisham.
Findings
QS11 implementation ranged from no implementation to full implementation across the 13 statements. Implementation quality was also reported to vary widely across different settings. The analyses also uncovered numerous barriers and facilitators to implementing each statement. Overarching barriers to implementation included: inherent differences between specialist vs generalist settings; poor communication between healthcare settings; generic barriers to implementation; and poor governance structures and leadership.
Research limitations/implications
QS11 was created to summarise alcohol-related NICE guidance. The aim was to simplify guidance and enhance local implementation. However, in practice the standard requires complex actions by professionals. There was considerable variation in local alcohol commissioning models, which was associated with variation in implementation. These models warrant further evaluation to identify best practice.
Originality/value
Little evidence exists on the implementing quality standards, as distinct from clinical practice guidelines. The authors present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.
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