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This research paper aims to explore the added value of knowledge management (KM) and its antecedents for innovation and organizational performance (OP) in marginal healthcare organizations.

Using insights from the resource-based view and knowledge-based theory of the firm, the model explains the effects of technology capabilities (TC) and organizational culture (OC) on the KM process, process innovation (PIN), administrative innovation (AIN) and OP. The authors used partial least squares structural equation modeling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) to analyze data collected from 168 healthcare practitioners in Cameroon using a survey.

The authors reveal that TC and OC positively impact some KM components. Knowledge sharing (KS), knowledge acquisition (KA) and responsiveness to knowledge (RK) influence PIN, while only PIN and KA influence OP. FsQCA provided several configurations that lead to high OP within healthcare centers. As a result, the results are adaptable to any healthcare center that wishes to set up one or more KM processes.

Given that the results will help the health workforce make concerted decisions about medical care, the authors contribute significantly to the definition and optimization of KM in healthcare by implementing various processes and policies to ensure the continued existence of high-quality and outstanding healthcare systems. The KM propositions will enable healthcare centers to: (1) improve the quality of patient care through collegiality in medical practice; (2) optimize processes in the patient care chain; and (3) leverage knowledge gained though knowledge sharing among the medical team. The propositions open up avenues for future research in addition to providing practical implications for healthcare center practitioners.

This study sheds new empirical light on the relationships between KM antecedents and processes, innovation and OP in healthcare centers. This research is one of the few to examine the relationship between TC, OC, KM processes, innovation and OP in developing countries. This paper aims to fill this gap and inform future research concerning KM in the healthcare sector. Further, this study goes beyond testing the PLS-SEM approach's hypotheses by applying fsQCA to provide practical and comprehensive knowledge on how to increase the efficiency of a healthcare center through KM.

This chapter provides a reflective synopsis of six cases focused on making healthcare sustainable. The nature and value of an ecosystem perspective is explored. The intent is to apply and generate organizational knowledge to understand and guide purposeful design and learning.

From five countries where healthcare is organized differently, these cases illuminate particular approaches to develop the capabilities for healthcare to deliver greater value to society. Each case is examined through the lens of an appropriate theoretical perspective. This chapter reports the themes that were common in the six case studies.

New approaches are changing the connections in the healthcare ecosystem, including the flows of: medical knowledge, clinical information, and resources. Common themes include: the importance of networks in the emerging healthcare ecosystem; the role of governance mechanisms and leadership to align the diverse ecosystem components; the engagement of dominant ecosystem actors; the need for adaptive change capabilities, and for multi-stakeholder research collaborations to generate actionable knowledge.

Taking an ecosystem perspective enables healthcare leaders to broaden their conceptualization of the changes that will be required to be sustainable in a changing society.

Almost every man, woman and child is affected by the healthcare system. Increasing the sustainability of healthcare is integral to increasing societal sustainability overall.

Viewing the ecosystem as the appropriate focus of purposeful change departs from a traditional approach that focuses on the effectiveness of each element.

High quality healthcare is important to all patients. If healthcare is felt to be high quality, then patients will be satisfied, and the relationship between patients and healthcare providers will improve. Patient satisfaction is among the most commonly used service quality indicators; however, it is not fully known which factors influence satisfaction. Therefore, it is necessary to pay attention to the elements that affect both healthcare quality and patient satisfaction. Nowadays, several methods are used in health economics to assess patient preferences, prioritize them and help health policy makers improve services. Discrete choice experiment (DCE) is one method that is useful to elicit patient preferences regarding healthcare services. The purpose of this paper is to apply DCE and elicit patient preferences in medical centers to rank certain healthcare quality factors.

The descriptive, analytical study used a cross-sectional questionnaire that the authors developed. In total, 12 scenarios were chosen after applying fractional factorials. The questionnaire was completed by patients who were admitted to Kerman General Teaching Hospitals, South-East Iran in 2015. Patient preferences were identified by calculating the characteristics’ marginal effects and prioritizing them. The generalized estimation equation (GEE) model was used to determine attribute effects on patient preferences.

In total, 167 patients completed the questionnaire. Prioritizing the attributes showed that “physical examination” was the most important attribute. Other key features included “cleanliness,” “training after discharging,” “medical staff attention,” “waiting for admission” and “staff attitude.” All attributes were statistically significant (p<0.05) except staff behavior. No demographic characteristic was significant.

To increase hospital patient satisfaction, health policy makers should develop programs to enhance healthcare quality and hospital safety by increasing physical examination quality and other services.

To estimate DCE independent variables, logistic regression models are usually used. The authors used the GEE model to estimate discrete choice experiment owing the explanatory variables’ dependency.

In the context of a much higher infant mortality rate (IMR) among Blacks than among Whites in the USA, the purpose of this paper is to compare changes in IMR in the two groups to judge whether the rates of decline are indicative of the so‐called Matthew‐effect or the inverse‐care principle, which, in contrast with the usual expectation of “diminishing marginal product,” suggests that higher level of IMR would be associated with a slower rate of IMR decline.

Changes in the IMR for each group over the period 1980‐2007 are studied. Levels and rates of decline in the two groups are compared for 1980‐1990, 1990‐2000, and 1980‐2007 for the USA. In addition, the levels and rates of decline in the two groups over these periods are also compared for each state.

Despite the much higher level of IMR among Blacks, the rates of decline in IMR over 1980‐1990, 1990‐2000, and 1980‐2007 are considerably lower for Blacks than for Whites when data for the entire USA are considered. Moreover, the same pattern is observed for a vast majority of the states in each period.

This is perhaps the only study that considers the possible operation of the inverse‐care principle relative to Black and White IMR in the USA over a fairly long period. The findings suggest several useful points. First, the pattern is consistent with the Matthew‐effect or the inverse‐care principle, and is not supportive of the usual expectation of “diminishing marginal product” in healthcare improvements. Second, the observed pattern seems to reflect poorer access of Blacks to prenatal, maternal, and infant healthcare. Third, it appears likely that, as suggested by Hart and indicated by recent research on increasing Black‐White IMR disparity, the pattern reflects a high degree of reliance on the market forces in healthcare provision and innovation, particularly relative to infant mortality. Fourth, in that context, greater role of the public sector in healthcare, particularly relative to IMR, might be given serious consideration. Fifth, given the observed pattern, the goal of eliminating racial disparities in IMR is unlikely to be met for a long time. Sixth, the relatively low‐international ranking of the USA in IMR, which has been declining, might not improve for quite some time.

Given the pace of industry change and the rapid diffusion of high reliability organization (HRO) approaches, lags and divergences have arisen between research and practice in healthcare. The purpose of this paper is to explore several of these theory-practice gaps and propose implications for research and practice.

Classic and cutting-edge HRO literature is applied to analyze two industry trends: delivery system integration, and the confluence of patient-as-consumer and patient-centered care.

Highly reliable integrated delivery systems will likely function very differently from classic HRO organizations. Both practitioners and researchers should address conditions such as how a system is bounded, how reliable the system should be and how interdependencies are handled. Additionally, systems should evaluate the added uncertainty and variability introduced by enhanced agency on the part of patients/families in decision making and in processes of care.

Dramatic changes in the sociotechnical environment are influencing the coupling and interactivity of system elements in healthcare. Researchers must address the maintenance of reliability across organizations and the migration of decision-making power toward patients and families.

As healthcare systems integrate, managers attempting to apply HRO principles must recognize how these systems present new and different reliability-related challenges and opportunities.

This paper provides a starting point for the advancement of research and practice in high-reliability healthcare by providing an in-depth exploration of the implications of two major industry trends.

This paper analyzed the healthcare systems of the Philippines and Vietnam prior to the coronavirus disease 2019 (COVID-19) and their strategies on mass testing, contact tracing, quarantine procedures and information dissemination about the pandemic.

Steinmo's (2008) historical institutionalism approach was used in this paper. Secondary data gathering, document analysis and comparative process tracing were employed.

The findings revealed that Vietnam's implementation of its Law on Prevention and Control of Infectious Diseases in 2007, its relatively low-cost healthcare system, its efficient mass testing and contact tracing strategies and its science-based decisions are contributory to its success in handling the pandemic. Meanwhile, the Philippines failure to enact its Pandemic and All-Hazards Preparedness Act in 2013, its costly and dominantly private healthcare system, its heavy focus on strict, long lockdowns and its militarist methods to control the spread of the pandemic were found to be insufficient.

Detailed study on the delivery of healthcare services in marginal areas, healthcare spending for COVID-19 positive individuals and information dissemination strategies about the pandemic were not explored.

Health institutions can redesign their governance mechanisms by ensuring a cost-effective healthcare system and maximizing resource utilization to ensure efficient management of future pandemics. Moreover, national governments should not compromise their country's healthcare system over the economy during a pandemic.

This paper analyzed the countries' history of healthcare governance and its influence in handling COVID-19 compared to previous studies which only focused on the countries' strategies during the pandemic.

The research outlined in this paper highlights the importance of certain factors related to primary health care buildings’ physical environment, such as the facility size, the functional efficiency, and the health planning of public areas in the health centers to improve the architectural space of health facilities.

This study was performed using a mixed method. Data collection was carried out through observational research and descriptive analysis in six primary health care facilities in Salvador and Lauro de Freitas, Brazil.

Based on this study’s results, facility capacity, functional efficiency and space accessibility have been considered the facilities’ main problems in the investigated context. The impact of the users’ perspective on healthcare facilities was assessed for each of these three criteria to verify the results obtained. Furthermore, most of the parameters were not satisfied, as the buildings analyzed had defects in their physical environment. Therefore, it is necessary to review and pay more attention to the architecture of these cities’ primary health care units.

The present study addresses the architectural environment design in Brazil’s healthcare facilities, which still have gaps. Improving the physical space of a health center ensures that the approach used in this research also applies to other health centers in similar contexts. The awareness that space’s activities and configurations will change according to each territory examined will open up so many investigation worlds.

This study examined the influence of income and health insurance on the health-seeking behaviour of rural residents, addressing the concerns of endogeneity and heterogeneity bias.

A two-stage residual inclusion was utilised to correct self-selection-based endogeneity problems arising from health insurance membership.

This study provides support for Andersen's behavioural model (ABM). Income and health insurance positively stimulate rural residents' use of modern healthcare services, but the effect of insurance risks a downward bias if treated as exogenous. Further, the effect of health insurance differs between males and females and between adults and the elderly.

This study advances the literature, arguing that, within the ABM framework, enabling (i.e. income and insurance) and predisposing factors (i.e. age and gender) complement each other in explaining rural residents' use of modern health services.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-03-2023-0223

The purpose of this chapter is to describe a method for priority setting that can be used to identify options for disinvestment, and is also meant to serve as a tool for re-allocation of resources to achieve better outcomes with a given pot of resources.

This chapter draws on findings from the application of a priority setting and resource allocation framework known as Program Budgeting and Marginal Analysis (PBMA). Case studies are used to illustrate key points around implementation including factors for success and guidelines for improving priority setting in practice.

PBMA has been applied in over 150 settings over the last 30 years. Purposes varied from focusing strictly on disinvestment to examining opportunities for re-allocation. Many organizations report continued use of the framework and decision makers typically express a desire to not revert to historical allocation or political negotiation in deciding on the funding for programs.

Practical implications of this body of work on priority setting abound in that there are significant opportunities to improve resource allocation practice including better engagement of staff, clinicians and public members, greater use of evidence in decision making and improving process transparency.

As healthcare resources are limited, particularly in predominantly publicly funded health systems, prudent use of resources is critical. Actually applying the appropriate tools to ensure that funding aligns with organizational and system objectives is paramount.

Although there is a large body of literature on priority setting particularly in countries like the United Kingdom and Canada, this chapter serves to highlight key messages specifically in the context of fiscal constraint and in relation to the concept of disinvestment or service reduction.

This paper aims to provide a history of graduate healthcare management education in the USA with an emphasis on the comparison of business schools and health science settings. It seeks to explain why different organizational cultures exist and how this affects education.

The approach relies on literature review and descriptive analysis using secondary data. Institutional economics helps provide perspective on different academic cultures and orientations.

Healthcare management education originated in the early twentieth century. Business schools at the University of Chicago and Northwestern were early pioneers. By mid‐century, schools of public health and medicine entered and came to dominate with strong graduate programs at Berkeley, Michigan and other leading universities. More recently, business schools have differentiated away from the generic MBA and expanded into this market. Advocates of health science settings commonly see healthcare as different from other forms of management. The externally funded model of medical education relying on patient and grant revenues dominates the health sciences. This can lead to preference for faculty who generate funds and a neglect of core academic areas that historically have not relied on grants and contracts.

This history of health management education provides insight for students, researchers, educators and administrators. It underscores comparative advantage of different academic settings.

This paper serves to fill a gap in the management literature. It provides history and perspective about academic settings not readily available.