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Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

In response to growing concerns over the negative consequences of Internet addiction on adolescents’ mental health, coupled with conflicting results in this literature stream, this meta-analysis sought to (1) examine the association between Internet addiction and depressive symptoms in adolescents, (2) examine the moderating role of Internet freedom across countries, and (3) examine the mediating role of excessive daytime sleepiness.

In total, 52 studies were analyzed using robust variance estimation and meta-analytic structural equation modeling.

There was a significant and moderate association between Internet addiction and depressive symptoms. Furthermore, Internet freedom did not explain heterogeneity in this literature stream before and after controlling for study quality and the percentage of female participants. In support of the displacement hypothesis, this study found that Internet addiction contributes to depressive symptoms through excessive daytime sleepiness (proportion mediated = 17.48%). As the evidence suggests, excessive daytime sleepiness displaces a host of activities beneficial for maintaining mental health. The results were subjected to a battery of robustness checks and the conclusions remain unchanged.

The results underscore the negative consequences of Internet addiction in adolescents. Addressing this issue would involve interventions that promote sleep hygiene and greater offline engagement with peers to alleviate depressive symptoms.

This study utilizes robust meta-analytic techniques to provide the most comprehensive examination of the association between Internet addiction and depressive symptoms in adolescents. The implications intersect with the shared interests of social scientists, health practitioners, and policy makers.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

Apples have always been considered a healthy product able to provide curative properties to consumers. In Italy, there is a long tradition of apple consumption and production both as a fresh product and as processed food. However, as with many other products, the consumption of fruits and vegetables and, more specifically apples, has been drastically affected by the first lockdown in 2020. In this project, the authors investigate whether the change in consumption habits had long-lasting consequences beyond 2020 and what are the main eating motivations, food-related behavior and socio-demographic affecting the consumption of fruits and vegetables after the pandemic.

The authors ran two online surveys with 1,000 Italian consumers across a year (from October 2021 to December 2022). In the study, participants answered questions about their consumption habits and their eating motives. Out of 1,000 consumers, the authors included in the final analysis only the participants who answered both surveys, leaving a final sample of 651 consumers.

The results show that participants have allocated more budget to fruit and vegetables after the lockdown than before it. Moreover, consumers reported an average increase in the consumption of apples. However, the increase was more pronounced for people aged between 30 and 50 years old and identified as female. After showing the difference across time, a cluster analysis identified three main segments that differ in their eating motives, place of purchase and area of residence.

Overall, the results contribute to a better understanding of how the global pandemic is still affecting people's daily life. Moreover, the findings can be used to guide the marketing and communication strategies of companies in the food sector.

To the best of the authors' knowledge, this is the first study that investigates changes in the consumption of fruits and vegetables, and, more specifically, apples, in Italy more than one year after the beginning of the COVID-19 pandemic. Moreover, the study proposes a classification of consumers based on their habits in a time frame during which the COVID-19 wave was at its bottom which is not currently present in the literature.