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This paper aims to examine whether medical tourism can be a frontrunner in terms of post-pandemic recovery for the industry

A mixed-method analysis of 17 interviews and 210 questionnaires involving medical tourists to Iran was applied.

Medical tourists perceived the risks posed by COVID-19 as a temporal one, and attitudes toward post pandemic visitation intentions remained strong. In addition, these tourists can mostly be classified into responsive individuals, who demonstrate not only high risk but also high efficacy levels to negotiate the threats posed by the pandemic. No gender differences were located between male and female medical tourists in terms of post-COVID-19 travel intentions to Iran.

This research extends the application of the risk perception attitude framework to a medical tourism context. Furthermore, medical tourists are uncovered as another segment of crisis-resistant tourists.

The purpose of this paper is to identify the factors influencing the visit intention of medical tourists to India. This study also attempts to extend the theory of planned behaviour through the integration of perceived risk and facilitating condition.

Primary data were collected from a sample of 326 medical tourists arriving in India through Terminal-3 of Indira Gandhi International Airport (IGI-T3), New Delhi, India, during the months of October–December 2019. Confirmatory factor analysis and structural equation modelling are deployed to analyze the collected data and validate the proposed research model.

The outputs of this study revealed that perceived financial risk, physical risk, psychological risk and facilitating conditions available in a country are significantly linked to the attitude of a medical tourist. Similarly, facilitating conditions available in a country are significantly related to perceived behavioural control of a medical tourist. Furthermore, it is also revealed that attitude, subjective norm and perceived behavioural control are significantly related to visit intention of medical tourists to India; however, the perceived time risk and performance risk are insignificantly associated with the visit intention.

This study is restricted to the opinion of 326 sample respondents consisting of medical tourists who arrived in India through IGI-T3, New Delhi, during October–December 2019. In the future, a similar type of study may be conducted in different parts of the country with a relatively larger sample size

This study addresses the need for advancing the knowledge on the factors in determining visit intention of medical tourists towards India. This knowledge will become very crucial for India's medical tourism industry, which is aiming to attain a competitive edge in the global market.

The purpose of this paper is to describe the relationship between job stress, stress coping ability and performance among Japanese nurses.

Health risk and organization environment as job stress factors, sense of coherence (SOC) as stress coping ability and medical risk indicator and sickness‐absence days as a performance proxy were used to investigate the relationship between stress and performance. Length of professional experience also was included in the investigation.

The findings suggest a possibility that enriching nurses' professional experiences reduces medical risk. There is also a possibility that raising the SOC, while improving organization environment, contributes to reducing sickness‐absence.

A cross‐sectional study of nurses in a single institution was used. In order to generalize the study's results, it will be necessary to conduct multi‐institutional longitudinal studies.

The present study shows key factors affecting medical risk and sickness‐absence leading to a reduced nursing performance.

Medical technologies and assets are one of the main drivers of increasing healthcare cost. The rising number and complexity of medical equipment have forced hospitals to set up and regulate medical equipment management programs to ensure critical devices are safe and reliable. The purpose of this paper is to gain insights into maintenance management-related activities for medical equipment. The paper proposes applying a tailored reliability-centered maintenance (RCM) approach for maintenance activities selection for medical equipment. Such approach will support assets management teams in enhancing operation, decrease risk and cost, and ultimately improve health of patients served by these equipment.

The traditional RCM approach will be used with a focus on criticality reduction. By criticality, the authors refer to the severity of failures and occurrence. The proposed method relies on the use of reliability growth analysis for opportunity identification followed by a thorough failure mode and effect analysis to investigate major failure modes and propose ways to reduce criticality. The effectiveness of the proposed method will be demonstrated using a case of one of the leading obstetric and gynecological hospitals in United Arab Emirates and in the Gulf Cooperation Council region.

The case examines the relationship between the current practice of planned preventive maintenance and the failure rates of the equipment during its life span. Although a rigorous preventive maintenance program is implemented in the hospital under study, some critical equipment show an increasing failure rates. The analysis highlights the inability of traditional time-driven preventive maintenance alone in preventing failures. Thus, a systematic RCM approach focused on criticality is more beneficial and more time and cost effective than traditional time-driven preventive maintenance practices.

The study highlights the need for utilizing RCM approach with criticality as the most important prioritization criterion in healthcare. A proper RCM implementation will decrease criticality and minimize the risk of failure, accidents and possible loss of life. In addition to that, it will increase the availability of equipment, and reduce cost and time.

This paper proposes a maintenance methodology that can help healthcare management to improve availability and decrease the risk of critical medical equipment failures. Current practices in healthcare facilities have difficulty identifying the optimal maintenance strategy. Literature focused on medical maintenance approach selection is rather limited, and this paper will help in this discussion. In addition to that, the Association for the Advancement of Medical Instrumentation supports the initiative of adopting RCM on a large scale in healthcare. Therefore, this paper address the gap in the literature for medical equipment maintenance and the work is in line with the recommendation of leading healthcare association. The paper also presents statistical review of the total number of received maintenance work orders during one full year in the hospital under study. The analysis supports the need for more research to examine current practice and propose more effective maintenance approaches.

Inventory management systems in health-care supply chains (HCSC) have been pushed to breaking point by the COVID-19 pandemic. Unanticipated demand shocks due to stockpiling of medical supplies caused stockouts, and the stockouts triggered systematic supply chain (SC) disruptions inconceivable for risk managers working individually with limited information about the pandemic. The purpose of this paper is to respond to calls from the United Nations (UN) and World Health Organization (WHO) for coordinated global action by proposing a research agenda based on a review of current knowledge and knowledge gaps on the role of collaboration in HCSCs in maintaining optimal stock levels and reinforcing resilience against stockout disruptions during pandemics.

A systematic review was conducted, and a total of 752 articles were analyzed.

Collaborative planning, forecasting and replenishment practices are under-researched in the HCSC literature. Similarly, a fragmented application of extant SC collaborative risk management capabilities undermines efforts to enhance resilience against systematic disruptions from medical stockouts. The paucity of HCSC articles in humanitarian logistics and SC journals indicates a need for more research interlinking two interdependent yet critical fields in responding to pandemics.

Although based on an exhaustive search of academic articles addressing HCSCs, there is a possibility of having overlooked other studies due to search variations in language controls, differences in publication cycle time and database search engines.

The paper relies on COVID-19's uniqueness to highlight the limitations in optimization and individualistic approaches to managing medical inventory and stockout risks in HCSCs. The paper proposes a shift from a fragmented to holistic application of relevant collaboration practices and capabilities to enhance the resilience of HCSCs against stockout ripple effects during future pandemics. The study propositions and suggestion for an SC learning curve provide an interdisciplinary research agenda to trigger early preparation of a coordinated HCSC and humanitarian logistics response to future pandemics.

The purpose of this paper is to provide an understanding on implementation and operation of ISO 13485:2003 – “Medical Devices – Quality Management System – Requirements for Regulatory Purposes” – in the perspective of medical device industries in Malaysia. The study is focused on the Malaysian Small and Medium Enterprises (SMEs) which currently have accredited to ISO 9001:2000 quality management systems.

Literature research and comparative analysis between ISO 13485:2003 and ISO 9001:2000 standard and requirements. A reference model is developed to assist the Malaysian SMEs towards ISO 13485:2003 accreditation.

Unlike ISO 9001:2000, ISO 13485:2003 stresses the safety and efficacy of medical devices that are being produced. For this reason risk management is an essential process that needs to be adopted into the ISO 13485:2003 quality management system. Moreover, to demonstrate the effectiveness of the ISO 13485:2003 implementation, this standard has placed great emphasis on documentation requirements which are more prescriptive in insisting on the use of formal procedures.

The paper provides guidelines to ISO 13485:2003 implementations as well as risk management approaches for small and medium‐sized businesses of Malaysian medical device manufacturers, which at the same time maintains its ISO 9001:2000 certification.

As biomedicine becomes increasingly enmeshed in modern life, biomedicalization processes have implications for reproductive policy, including abortion policy. Informed consent provisions have been a prominent trend in state-level abortion lawmaking in the United States in recent years. Modeled on the practice of securing informed consent for medical procedures, informed consent provisions stipulate the information a person must receive before they can consent to an abortion. Informed consent provisions purportedly require that this information be objective, scientifically accurate, and non-judgmental. Through an analysis of informed consent provisions in Texas abortion legislation from 1993 to 2015, this chapter explores how such provisions employ medical and biomedical tropes to frame regulations that restrict access to abortion care as ostensibly protecting women’s health and safety. I find that informed consent legislation in Texas selectively borrows from medical and biomedical lexicons, cites strategic empirical evidence, and co-opts medical techniques and experts in ways that encumber abortion access.

Little is known about perceptions of medical expenditure risks despite their presumed relevance to the demand for health insurance. This is the first study to examine households’ beliefs about their future spending on health care. The study made a unique elicitation of subjective probabilities of medical expenditures from rural Ethiopians participating in a panel survey and offered the opportunity to enrol in a health insurance programme. The vast majority of respondents give logically consistent responses to the subjective probability questions. The data indicate that the cross-sectional variance of realized expenditures, which is often used to proxy risk exposure, greatly overestimate the risk faced by any single household. Consistent with the serial correlation observed in realized expenditures, expectations are positively correlated with past expenses. They are revised upward in response to an increase in realized expenditure and, to some extent, they predict expenditure incurred in the year ahead. Despite containing information on future medical expenditures, there is no evidence that expectations influence the decision to take out health insurance, although plans to insure are positively related to the perceived volatility of expenses.

These results suggest that adverse selection may not threaten the viability of voluntary health insurance. A caveat is that measurement error in the reported probabilities may weaken the test for adverse selection. Notwithstanding this limitation, measurement of household-specific distributions of future medical expenses is feasible and avoids relying on the cross-sectional variance, which provides an upwardly biased estimate of medical expenditure risk.

If rational individuals pay the full costs of their decisions about food intake and exercise, economists, policy makers, and public health officials should treat the obesity epidemic as a matter of indifference. In this paper, we show that, as long as insurance premiums are not risk rated for obesity, health insurance coverage systematically shields those covered from the full costs of physical inactivity and overeating. Since the obese consume significantly more medical resources than the non-obese, but pay the same health insurance premiums, they impose a negative externality on normal weight individuals in their insurance pool.

To estimate the size of this externality, we develop a model of weight loss and health insurance under two regimes – (1) underwriting on weight is allowed and (2) underwriting on weight is not allowed. We show that under regime (1), there is no obesity externality. Under regime (2), where there is an obesity externality, all plan participants face inefficient incentives to undertake unpleasant dieting and exercise. These reduced incentives lead to inefficient increases in bodyweight, and reduced social welfare.

Using data on medical expenditures and bodyweight from the National Health and Interview Survey and the Medical Expenditure Panel Survey, we estimate that, in a health plan with a coinsurance rate of 17.5%, the obesity externality imposes a welfare cost of about $150 per capita. Our results also indicate that the welfare loss can be reduced by technological change that lowers the pecuniary and non-pecuniary costs of losing weight, and also by increasing the coinsurance rate.

The identification of the main risk triggers is essential for the hospital’s survival and performance with direct effects on its patients’ health and well-being. For this reason, in this paper some of the most important risk categories have been determined. While in a previous research a qualitative analysis has been done for determining which are the most important risks felt by the patient that are believed to affect their health through the usage of a questionnaire and through conducting a confirmatory factor analysis, the purpose of this paper is to analyze the quantitative side of these risks’ presence in a hospital.

On this purpose, four main categories of risks have been considered (the same as in the qualitative research) and they have been analyzed from the hospital’s point of view – through the usage of the hospital financial and internal documents. Therefore, a series of indicators have been determined for each risk category. After that, a representative indicator has been selected and the grey incidence analysis has been conducted.

By comparing the results gathered form this study with the qualitative analysis conducted among the patients (Delcea et al., 2016) it can be said that there can be seen a difference among the way a hospital and a patient perceive the risks within a medical activity. While for the hospital, the most affecting risk is the technological and hospital conditions risk, for the patients the most affecting risk seems to be the human resources and clinical risk. The mismanagement risk and inability to treat patients is the second in intensity for both the hospital and patients, with a smaller value in the patients’ case.

From here, the research can be extended for capturing the risks that are considered to be important for the medical stuff, which will permit us to have a global image over the healthcare risks. After that, a comparative analysis among the hospitals with different financial performance can be conducted in order to see how these risks are affecting their performance and to determine which can be the decisions that can fostering the reduction of these risks.

The present paper offers a quantitative analysis from the hospital’s point of view using the advantages offered by the grey systems theory. Combining this analysis with a qualitative one conducted on the patients, the managers of the hospital can a have a more adequate view over the risks that they are facing with. In this context, grey systems theory offers the needed methods for dealing with such situations.