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Article
Publication date: 18 July 2023

Linda H. Chen, Leslie Eldenburg and Theodore H. Goodman

The purpose of this study is to investigate how two types of drivers, namely, executive compensation and market competition, can affect hospital quality in the USA. Recently…

Abstract

Purpose

The purpose of this study is to investigate how two types of drivers, namely, executive compensation and market competition, can affect hospital quality in the USA. Recently, patients, insurers and regulators have increasingly focused on hospital quality. Understanding the interplay of incentives in this industry is important because in 2019, hospital treatment contributed $1.161bn to health-care costs in the USA. This study answers the call for more studies in the so-called “mixed” industry, where ownership differences can affect organizational objectives and operating constraints.

Design/methodology/approach

This study explores the roles of hospital executive compensation and industry competition as determinants of health-care quality. Specifically, the study probes the heterogeneity in the factors that influence quality across hospital types in the USA.

Findings

Using California hospital data from 2006 through 2020, the findings show that the effects of compensation and competition on hospital quality differ by ownership type. Executive compensation is positively associated with quality in for-profit hospitals but is not associated with that of nonprofit hospitals, suggesting for-profit hospitals are more likely to use higher levels of compensation to attract managers with higher ability, whereas the utility function for nonprofit managers may be multidimensional. Within the nonprofit hospital group, competition is more positively associated with quality for religious nonprofits relative to secular nonprofits, suggesting that competition provides more monitoring for religious hospitals.

Originality/value

Taken together, the findings provide evidence that the drivers of quality vary across hospitals in ways consistent with differences in constraints and objectives across ownership types. The findings are important for regulators seeking to incentivize higher quality. For example, Medicare in the USA has incorporated quality measures into its new hospital reimbursement scheme (value-based purchasing) to incentivize quality. This study proposes that regulators should consider differences across ownership types when evaluating the best ways to incentivize hospital quality.

Details

Review of Accounting and Finance, vol. 22 no. 4
Type: Research Article
ISSN: 1475-7702

Keywords

Article
Publication date: 7 June 2023

Eduard Aneste and Oleg Lozan

Identifying the perception of competition between public and private providers in the national hospital market can help authorities to develop appropriate management strategies…

Abstract

Purpose

Identifying the perception of competition between public and private providers in the national hospital market can help authorities to develop appropriate management strategies applicable to the hospital sector and increase the efficiency of public hospital institutions.

Design/methodology/approach

A mixed selective descriptive study including quantitative and qualitative components was carried out on in the Republic of Moldova between 12/2021 and 03/2022. The study included all hospitals in the country. The study revealed the hospital manager's perception of the hospital's competition as respondents to the questionnaire were only the directors and managers of hospital institutions. The concept of evaluation of the perception of competition was carried out through the lens of “Porter's 5 forces” from “Competitive strategies” by Michael E. Porter. The authors used a questionnaire as an instrument for studying the perception of competition. All study participants responded to both the quantitative and qualitative questionnaire.

Findings

Interhospital competition perceived by managers using model framework of “Porter's 5 forces” reveals high danger from service providers and high perception of rivalry; hospital directors perceived as low: the patient's bargaining power; the danger of new competitors entering the market; the danger of substitution, which constitutes competitive advantages; the lack of autonomy in the selection of services and patients and legislative barriers are the main perceived dissensions. The perception of competition between public and private hospitals is one with high rivalry, especially in the country's municipalities.

Originality/value

The national public hospital system takes up to 65% of the health budget being extremely expensive, a fact that indicates a rather low competitiveness of them. The European average indicates figures of 30–40%. The private hospital sector is less developed compared to most European countries, being represented by 17 institutions, in comparison Romania has 104 private hospitals representing about 25% of the market share. Private hospitals also occupy a considerable part of the European hospital healthcare market, continuing to increase, reaching over 30% in Germany.

Details

International Journal of Health Governance, vol. 28 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 4 September 2023

Akanksha Mishra and Neeraj Pandey

This study aims to map and analyze health-care pricing information research. This work highlights current gap in pricing information research in health care and proposes future…

Abstract

Purpose

This study aims to map and analyze health-care pricing information research. This work highlights current gap in pricing information research in health care and proposes future research avenues to academia and industry professionals.

Design/methodology/approach

A bibliometric method was adopted to analyze extant literature on pricing information asymmetry. Semistructured interviews were conducted with key stakeholders in health care to triangulate the findings.

Findings

Pricing information is crucial for all stakeholders including health-care consumers, providers and regulators. The popular research areas were the rising health-care cost, cost-saving, outcome-based pricing, price based on service supply and demand, insurance and out-of-pocket spending. Cost–quality perceived linkages, cost–demand correlation in health-care service and cost–price interlinked drivers were the dominant themes in extant literature. The study highlighted that pricing information asymmetry pushed patients from weaker sections into a debt trap due to unplanned out-of-pocket health-care expenses. The study suggests areas of research to minimize this pricing information asymmetry.

Practical implications

The emerging themes in health pricing asymmetry will help key stakeholders to identify areas for improvement and take remedial actions in the health-care domain.

Originality/value

This study is a pioneering effort to summarize extant literature published in the health-care information pricing domain and analyze it from a bibliometric perspective. The study also triangulates the finding with primary data from key stakeholders and highlights emerging research areas.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 17 no. 4
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 22 November 2023

Ngatindriatun Ngatindriatun, Muhammad Alfarizi and Rafialdo Arifian

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department…

Abstract

Purpose

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

Design/methodology/approach

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Findings

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

Originality/value

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

Details

Journal of Modelling in Management, vol. 19 no. 3
Type: Research Article
ISSN: 1746-5664

Keywords

Article
Publication date: 16 January 2023

Gregory Stock and Christopher McDermott

The authors examine how physician staffing, human capital and knowledge spillovers are related to multiple dimensions of hospital operational and financial performance at the…

Abstract

Purpose

The authors examine how physician staffing, human capital and knowledge spillovers are related to multiple dimensions of hospital operational and financial performance at the organizational level.

Design/methodology/approach

The authors use a data set assembled from multiple sources for more than 1,300 US hospitals and employ hierarchical linear regression to test this study’s hypotheses. The authors use multiple quality, efficiency and financial measures of performance for these hospitals.

Findings

The authors find that higher levels of staffing, skills and knowledge spillovers associated with physicians were positively associated with multiple dimensions of hospital performance. The authors find linear and nonlinear relationships between experience and performance, with the relationships primarily negative, and nonlinear relationships between spillovers and quality performance.

Practical implications

Hospital managers should consider increasing physician staffing levels if possible. In addition, the overall Final MIPS Score from the Centers for Medicare and Medicaid Services might be included as a factor in determining which physicians practice in a hospital. Finally, if possible, encouraging physicians to practice at multiple hospitals will likely be beneficial to hospital performance.

Originality/value

This study’s findings are original in that they explore how physician-specific staffing and human capital, which have received comparatively little attention in the literature, are related to several different dimensions of hospital-level operational and financial performance. To the best of the authors’ knowledge, this paper is also the first to examine the relationship between the construct of physician knowledge spillovers and hospital-level operational and financial performance.

Details

International Journal of Operations & Production Management, vol. 43 no. 7
Type: Research Article
ISSN: 0144-3577

Keywords

Article
Publication date: 19 February 2024

Ricardo Santa, Diego Morante, Thomas Tegethoff and Luis Berggrun

The purpose of this study is to determine the interactions between factors such as organizational learning, feedback about errors, punitive response to errors and communication…

Abstract

Purpose

The purpose of this study is to determine the interactions between factors such as organizational learning, feedback about errors, punitive response to errors and communication quality in hospitals in the Kingdom of Saudi Arabia and Colombia when adopting a culture of quality and safety (CQS) in patient care.

Design/methodology/approach

Based on a literature review, a self-administered questionnaire was developed and used to collect data from 417 Saudi respondents affiliated with hospitals and 483 Colombian respondents at the beginning of the pandemic. Structural equation modeling is used in this study to test the hypothesized relationships.

Findings

The results show a solid and significant predictive relationship between feedback about errors and the CQS in both countries (Colombia: b = 0.55, p < 0.001; KSA: b = 0.44, p < 0.001), but a very low and insignificant predictive relationship between no punitive response to errors and CQS (Colombia: b = –0.02, p > 0.05; KSA: b = 0.05, p > 0.05).

Practical implications

This study demonstrates the importance of organizational learning in fostering a CQS in the health-care sector in the Kingdom of Saudi Arabia and Colombia. Recent unprecedented policy actions motivated by the COVID-19 pandemic, such as social distancing, lockdowns and safety practices enforcement, have further highlighted this concern. Moreover, attention to the dimensions addressed in this study is required for accreditation purposes in organizations seeking to promote a CQS. Overall, this research highlights the vital role of safety and quality practices among health-care organizations, which has significant policy implications, especially in the current period of high uncertainty.

Originality/value

This paper contributes to the theory and practice in the health-care sector by extending the current knowledge of the impact of the quality of communications, non-punitive response to errors and feedback about errors in organizational learning and safety culture, and by presenting a novel, quantitative methodology seldom used for these topics.

Details

International Journal of Quality and Service Sciences, vol. 16 no. 1
Type: Research Article
ISSN: 1756-669X

Keywords

Article
Publication date: 30 December 2021

Mohammad Hossein Saraei, Ayyoob Sharifi and Mohsen Adeli

The purpose of this study is to optimize the location of hospitals in Gorgan, Iran, to provide desirable services to citizens in the event of an earthquake crisis.

Abstract

Purpose

The purpose of this study is to optimize the location of hospitals in Gorgan, Iran, to provide desirable services to citizens in the event of an earthquake crisis.

Design/methodology/approach

This paper, due to target, is practical and developmental, due to doing method is descriptive and analytical and due to information gathering method is documental and surveying. In the present study, the capabilities of genetic algorithms and imperialist competition algorithm in MATLAB environment in combination with GIS capabilities have been used. In fact, cases such as route blocking, network analysis and vulnerability raster have been obtained from GIS-based on current status data, and then the output of this information is entered as non-random heuristic information into genetic algorithms and imperialist competition algorithm in MATLAB environment.

Findings

After spatial optimization, the hospital service process has become more favorable. Also, the average cost and transfer vector from hospitals to citizens has decreased significantly. By establishing hospitals in the proposed locations, a larger population of citizens can access relief services in less time.

Originality/value

Spatial optimization of relief centers, including hospitals, is one of the issues that can be of significant importance, especially in the event of an earthquake crisis. The findings of the present study and the originality, efficiency and innovation of the used methods can provide a favorable theoretical framework for the success of earthquake crisis management projects.

Details

International Journal of Disaster Resilience in the Built Environment, vol. 14 no. 3
Type: Research Article
ISSN: 1759-5908

Keywords

Article
Publication date: 20 October 2023

Joonhwan In, Randy Bradley, Bogdan C. Bichescu and Sumin Han

This study aims to examine the performance implications of an information governance (IG) framework for managing, controlling access to and securing information, focusing on (1…

Abstract

Purpose

This study aims to examine the performance implications of an information governance (IG) framework for managing, controlling access to and securing information, focusing on (1) the performance benefits of an organization's IG orientation and (2) how the configuration of IG orientation and supply chain (SC) strategy type relate to performance outcomes.

Design/methodology/approach

This study leverages multiple secondary sources for US hospitals, serving as the context for the study. It also employs cluster analysis to develop an SC strategy taxonomy, namely sophisticated and delivery-focused SC strategies. The proposed research model is tested using a robust regression to mitigate the influence of outliers and produce more accurate estimates.

Findings

IG orientation is positively associated with financial performance and patient experience, and IG-oriented hospitals with a sophisticated SC strategy realize more financial benefits and achieve better patient care experiences compared to other configurations. Regardless of SC strategy type, IG-oriented hospitals offer better care experiences than non-IG-oriented hospitals.

Practical implications

This paper offers empirical evidence that a hospital's IG orientation and SC strategy jointly affect financial outcomes and patient experience. For hospitals, an organization-wide framework for governing information streamlines both intra- and inter-organizational information flows and improves care delivery throughout a patient's care experience.

Originality/value

This is one of a few studies that empirically examine the performance implications of governance of information in the domain of supply chain management (SCM). This study also develops an SC strategy taxonomy for the healthcare context and offers a springboard for research in service SC strategy.

Details

The International Journal of Logistics Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0957-4093

Keywords

Article
Publication date: 13 January 2023

Hasan Bağcı and Seyhan Çil Koçyiğit

Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the…

Abstract

Purpose

Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the effects of the public hospital unions (PHUs), which were a result of Decree Law No. 663, on the efficiency and productivity of public hospitals.

Design/methodology/approach

Data envelopment analysis (DEA) and DEA-based Malmquist total factor productivity (TFP) index were used from 2011 to 2016. Raw materials and supply expenses, salaries and fringe benefits, other service costs, general administrative expenses, total number of beds, number of specialists, number of residents, number of general practitioners, number of nurses and midwives and other medical officials were used as input variables. Working capital turnover, number of inpatients, number of outpatients and number of surgical operations for Groups A, B and C were used as output variables.

Findings

According to the DEA scores, the percentage of efficient hospitals showed a declining trend from 2011 to 2016. The TFP results also showed a decreasing trend from 2011 to 2016.

Practical implications

Providing administrative and financial autonomy to public hospital managers may cause efficiency and productivity losses, which is contrary to expectations.

Originality/value

This study is the first to reveal the impact of decentralization of public healthcare providers on their performance levels in Turkey.

Details

Benchmarking: An International Journal, vol. 30 no. 10
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 1 February 2022

Songul Cinaroglu

This study aims to explore the nexus of equality and efficiency by considering public hospitals' development dynamics, capacity and technology indicators.

Abstract

Purpose

This study aims to explore the nexus of equality and efficiency by considering public hospitals' development dynamics, capacity and technology indicators.

Design/methodology/approach

Data was collected from the Ministry of Health Public Hospital Almanacs from 2014 to 2017. The Gini index (GI) is used to estimate the inequality of distribution of hospital performance indicators. A bias-corrected efficiency analysis is calculated to obtain efficiency scores of public hospitals for the year 2017. A path analysis is then constructed to better identify patterns of causation among a set of development, equality and efficiency variables.

Findings

A redefined path model highlights that development dynamics, equality and efficiency are causally related and health technology (path coefficient = 0.57; t = 19.07; p < 0.01) and health services utilization (path coefficient = 0.24; t = 8; p < 0.01) effects public hospital efficiency. The final path model fit well (X2/df = 50.99/8 = 6; RMSEA = 0.089; NFI = 0.95; CFI = 0.96; GFI = 0.98; AGFI = 0.94). Study findings indicate high inequalities in distribution of health technologies (GI > 0.85), number of surgical operations (GI > 0.70) and number of inpatients (GI > 0.60) among public hospitals for the years 2014–2017.

Originality/value

Study results highlight that, hospital managers should prioritize equal distribution of health technology and health services utilization indicators to better orchestrate equity-efficiency trade-off in their operations.

Details

International Journal of Productivity and Performance Management, vol. 72 no. 6
Type: Research Article
ISSN: 1741-0401

Keywords

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