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The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate how the main reform foci of productivity and quality are represented, with a specific focus on the patient.

Drawing on critical discourse analysis (CDA), the authors conduct a longitudinal study (2007–2018) of healthcare reporting foci across the five administrative regions responsible for public hospitals in Denmark. The study analyses sixty annual reports and draws on contemporary reform documents over this period. CDA enables a micro-textual analysis, combined with macro-insights and discussions on social practice.

The findings show complex webs of presentation strategies, but in particular two changes occur during the period. First, the patient is centred throughout but the framing changes from productivity and waiting lists to quality and dialogue. Second, in the first years, the regions present themselves as actively highlighting financial and quality concerns, which changes to a passive and indirect form of presentation steered by indicators and patient legislation enforced by central government. This enhances passivity and distance in healthcare regional non-financial reporting where the regions seek to conform to such demands. Simultaneously, however, the authors find a tendency to highlight very different local initiatives, which shows an attempt to go beyond a pure automatic mode of reporting found in earlier studies.

Responding to the literature on both healthcare and financial reporting, this study identifies novel links between micro-level texts and macro-level social practices, enabling insights into the potentially intertwined impacts of public-sector reporting. The authors offer insights into the complexity of the construction of non-financial reporting in the public sector, which has a wider impact and different intentions than private-sector reporting.

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in visiting brick-and-mortar clinics or hospitals during the pandemic, Telemedicine had emerged as a potent alternative for seeking redressal to health issues. Based on theory and focus interviews with the telemedicine users, the researchers proposed a model to understand the intent and actual usage of telemedicine in India.

The cross-sectional study undertaken used a questionnaire designed on a seven-point Likert scale and administered to respondents with the objective of identifying the determinants of intent and actual usage of telemedicine services. Simple random sampling was used to collect primary data. The data was cleaned and finally a sample of 405 responses complete in all respects was considered for analysis. The questionnaire comprised of 34 items and following the recommendation of Hair et al. (2016), which says the minimum sample size in structural equation modeling should be ten times the number of indicator variables, a sample size of 405 was deemed adequate.

The research paper finds that performance expectancy, attitude, credibility and self-efficacy positively impact the intention of consumers to use telemedicine services. As the effort expectancy or risk perception toward telemedicine increases the intent and actual usage of telemedicine decreases. The intention to use telemedicine emerged as a strong predictor of the actual usage of telemedicine. Intent to use telemedicine was explained 81.4% by its predictors of performance expectancy, effort expectancy, attitude, risk, credibility and self-efficacy, and actual usage was explained 79.9% by its predictors. This study also reports that telemedicine was found to be popular among chronic as well as episodic patients though the preference was skewed in favor of the episodic patients. One of the advantages of telemedicine is its availability round the clock, and the study found that 8 a. m. to 12 noon time slot as the most preferred slot for seeking telemedicine services.

Chang (2004) opined that telemedicine can fulfill the needs of all stakeholders: citizens, health-care consumers, medical doctors and health-care professionals, policymakers, and so on. Considering the promise telemedicine holds, this realm must be studied and leveraged to the full potential. The study found that patients were using telemedicine even for their day-to-day aliments. This indicates a growing popularity of telemedicine and as such an opportunity for telemedicine companies to leverage it. In India, pharmaceutical companies cannot give commercial advertisements for medicines, and the same can only be sold through a registered medical practitioner’s prescription. As such there is total dependency on the medical practitioner for the sale of medicines. Telemedicine companies offer services of home delivering medicines clubbed with medical consultation thus giving them forward integration in their business models. Using telemedicine the patients had control over the timings of the services offered, and as such the waiting time to get a consultation and subsequent treatment was reduced considerably. Best medical advice from across the globe is available to the patient at less cost. Medical practitioners also stand to benefit as they can treat a variety of cases, collaborate among the medical fraternity and give consultation safely in case of fatal contagious diseases.

This study points to a definite growing popularity of telemedicine services not only in episodic patients but also chronic patients. Telemedicine with its unique advantages holds the promise to grow exponentially in the future and is a compelling health-care segment to focus on for delivering health-care solution to the geographically distant consumers.

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

Applying the value-attitude-behavior (VAB) model, this study investigated how perceived utilitarian and hedonic values (i.e. novelty and emotion) affect individuals' attitudes toward medical hotels and how these attitudes, in turn, influence their intentions to stay at medical hotels. The current study also explored the moderating impact of overall health status on the relationships between perceived utilitarian, novelty and emotional values and attitudes toward medical hotels.

The data collected from 351 individuals who spent a night in a hospital to undergo medical treatment was used in conducting structural equation modeling to evaluate the research model and test the study hypotheses.

The study results revealed that perceived utilitarian, novelty and emotional values exerted a positive influence on individuals’ attitudes toward medical hotels, consequently enhancing their intention to stay. Additionally, significant moderating impacts of overall health status on the associations between perceived utilitarian, novelty and emotional values and attitudes toward medical hotels were observed.

The study findings provide useful guidance for professionals, such as operators, marketers and managers in medical hotels. These insights can improve operational and marketing strategies, benefiting both the industry and healthcare accommodation seekers.

This study is among the first to empirically assess a theoretical model that explored the influence of individuals' value perceptions within the realm of medical hotel establishments.

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances?

Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013).

The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system.

Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context.

This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.