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Article
Publication date: 1 April 2000

Janice Robinson and Siân Griffiths

New public health policies present social services with new opportunities and challenges. A shared public health and social care agenda is emerging around health

Abstract

New public health policies present social services with new opportunities and challenges. A shared public health and social care agenda is emerging around health improvement, social exclusion and regeneration. Early signs of synergy indicate that social services have a key role to play in shaping the public health agenda and in acting as a bridge between the NHS and the wider local authority.

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Journal of Integrated Care, vol. 8 no. 2
Type: Research Article
ISSN: 1476-9018

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Book part
Publication date: 1 January 2008

Mostafa Kamal Hassan

Purpose – The paper explains how internal reporting systems, as embedded practices informing organizational actions and “know-how”, contributed to the inertia in…

Abstract

Purpose – The paper explains how internal reporting systems, as embedded practices informing organizational actions and “know-how”, contributed to the inertia in implementing a corporate form of governance in a transitional public organization in a developing country – Egypt.

Design/methodology/approach – The paper synthesizes an institutional theory framework in order to capture the case study mixed results. Drawing on DiMaggio and Powell's (1983) notions of isomorphic mechanisms, Ocasio (1999) and Burns and Scapens’ (2000) notions of organizations’ memory, history, cumulative actions and routines, Brunsson's (1994) notion of organizational institutional confusion as well as Carruthers's (1995) notion of “symbolic window-dressing” adoption of new practices, the paper explores the dynamic of a public hospital corporatization processes. Data collection methods include semi-structured interviews, documentary evidence and direct observation.

Findings – The case study evidence shows that the interplay between the new form of “corporate” governance and the intra-organizational power, routines and “know-how” created internal organizational confusion and changed organizational members’ narrative of risk and uncertainties.

Research limitations/implications – The paper does not reveal the role of reformers involved in the public sector “governance” reform in developing countries. Exploring such a role goes beyond the scope of this paper and represents an area of future research.

Originality/value – The paper provides a comprehensive account of public sector “governance” reform in a developing nation, while exploring the role of management accounting and costing systems in facilitating or otherwise that reform processes.

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Corporate Governance in Less Developed and Emerging Economies
Type: Book
ISBN: 978-1-84855-252-4

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Article
Publication date: 16 September 2011

Marcus Roberts

The purpose of this paper is to examine the implications for drug and alcohol treatment of radical policy changes being implemented by the government, particularly the…

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358

Abstract

Purpose

The purpose of this paper is to examine the implications for drug and alcohol treatment of radical policy changes being implemented by the government, particularly the proposed transition of responsibility for treatment from the National Treatment Agency to a new public health service from 2013.

Design/methodology/approach

It is argued that this is a critical moment in the development of substance misuse services in England, particularly given the impact of health service reform. Concerns are raised about the lack of reference to drug and alcohol treatment in key policy documents, such as the Department of Health's White Paper Healthy Lives, Healthy People. The removal of the “ring fence” from the pooled treatment budget may result in national disinvestment at a time when public spending cuts are likely to reduce local authority spending on drug and alcohol treatment. It will be challenging to deliver on the vision of recovery in the “Drug strategy 2010”.

Findings

The new public health structures and the commitment to recovery create new opportunities to improve services too – for example, the potential for joint working through Health and Wellbeing Boards. It is also positive that Healthy Lives, Healthy People stated that the NHS Constitution will apply to the public health service.

Originality/value

While these changes could provide a platform for improving outcomes, there is a genuine risk that substantial disinvestment in drug and alcohol services will be witnessed.

Details

Drugs and Alcohol Today, vol. 11 no. 3
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 28 January 2020

Nirmala Nath, Radiah Othman and Fawzi Laswad

This paper aims to provide insights into how the New Zealand Office of the Auditor-General (NZOAG) legitimised the selection of topics for performance audit in the New…

Abstract

Purpose

This paper aims to provide insights into how the New Zealand Office of the Auditor-General (NZOAG) legitimised the selection of topics for performance audit in the New Zealand public health sector over a 10-year period, 2003-2013, by fulfilling the key actors’ “taken for granted beliefs” of the dual roles of the NZOAG: its independence and accountability.

Design/methodology/approach

This paper uses evidence gathered from interviews with representatives of the District Health Boards, the Ministry of Health (including Health Advisory Committee members) and NZOAG staff, along with publically available documentary evidence over a 10-year period. The authors draw on Suchman’s (1995) authority on institutional legitimacy to inform the research findings.

Findings

The New Zealand Auditors-General (NZAGs) get inputs from various sources such as their own audit teams, parliamentary deliberations, the Ministry of Health, the District Health Boards, media and public concerns and complaints. These sources initiate ideas for performance audits. Subsequently, the NZAGs use the recurring themes and risk assessment criteria while simultaneously consulting with the auditees (the MOH and the DHBs) and other actors, such as health advisory groups, to select topics for such audits. This signals to the key actors, such as the MOH and the DHBs, that the NZOAG is addressing the topics and concerns relevant to the former while discharging its public accountability role. Furthermore, the consultative approach acts as a catalyst, ensuring that the actors involved with public sector health service delivery, specifically the auditees, accept the selected topic. This leads to a lack of resistance to and criticism of the topic; the selection process, therefore, is legitimatised, and credibility is added to the audits. Because of the consultative approach taken by the NZAGs, the actors, including the performance auditors, continue to believe that the Office acts independently from third party influence in selecting their audit topics, elevating the NZAGs’ moral legitimacy with respect to their public accountability role.

Research limitations/implications

The study’s focus group does not include parliamentary representatives, only representatives from the DHBs, the MOH and the NZOAG; therefore, the conclusions on effective discharge of the NZOAG’s accountability role and Parliamentary acceptance is not conclusive – the NZOAG acts on behalf of the Parliament in discharging its accountability role and the latter is also the formal recipient of the reports.

Practical implications

The implications for practitioners and policymakers are that the use of a consultative approach to select topics for performance audit in the absence of performance auditing standards ensures auditee readiness and acceptance of such audits. This also promotes mutual benefits and “trust” between the AG and auditees. Such audits can be used to bring about efficacy in health service delivery.

Social implications

The selected topics for audits will have an impact on citizens’ lifestyles, with improved health services delivery.

Originality/value

There is a dearth of research on who initiates the ideas for performance auditing and how the Office of the Auditor-General selects topics for such audits. This study adds a new dimension to the existing performance auditing literature. The authors reveal how the NZOAG seeks to legitimise the selection of topics for such audits by consulting with the auditees and other actors associated with public sector health service delivery, while upholding its independent status and making transparent how it discharges its accountability role within the context of performance auditing.

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Qualitative Research in Accounting & Management, vol. 17 no. 2
Type: Research Article
ISSN: 1176-6093

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Article
Publication date: 10 July 2020

Sara Valadi-khorram, Mohammad Reza Amiri and Mohammad Karim Saberi

Considering the important role of public libraries in providing health information service as well as user feedback in improving the quality of health information services

Abstract

Purpose

Considering the important role of public libraries in providing health information service as well as user feedback in improving the quality of health information services, the purpose of this study is to evaluate the quality of health information service in public libraries of Hamadan, Iran, on the basis of the modified LibQUAL model

Design/methodology/approach

This practical research was conducted in an analytic-survey method. The statistical population consists of all members of public libraries of Hamadan over 18 years old (12,237 people), and the sample size is calculated to be 373 people. The stratified sampling method was used, and within each class, a convenience sampling method was used. The modified LibQUAL questionnaire was used to gather data. For checking normality of data distribution, the Kolmogorov–Smirnov test and for analyzing date, descriptive statistics and also Chi-square and Wilcoxon tests were applied using SPSS 25.

Findings

The users' minimum level of public libraries in all three dimensions is an average level. The users' desired level of “information control” is higher than other dimensions. The users' perceived level in dimensions of “human resources” and “information control” is high level, while users' perceived level in “educational service” is an “average” level. There is a superiority gap between desired and perceived level in all dimensions, but the adequacy gap was seen only in the dimension of “educational service.”

Research limitations/implications

In this study, the quality of health information services provided in public libraries is evaluated by the LibQUAL model.

Practical implications

The results of this research can help managers and librarians of public libraries in measuring the quality of health information services and improving the quality of services provided by libraries. Besides, they can take a more accurate planning and pathologic approach, to eliminate the gap between minimum and desired expectations of users and libraries’ real services.

Originality/value

In this study, the quality of health information services provided in public libraries is evaluated by LibQUAL tool.

Details

Library Management, vol. 42 no. 3
Type: Research Article
ISSN: 0143-5124

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Article
Publication date: 3 April 2017

Bylon Abeeku Bamfo and Courage Simon Kofi Dogbe

The study aims to examine the factors influencing the choice of private and public hospitals in Ghana.

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Abstract

Purpose

The study aims to examine the factors influencing the choice of private and public hospitals in Ghana.

Design/methodology/approach

Purposive and convenient sampling techniques were used in selection of 225 respondents for the study. An independent samples t-test was used in ascertaining the significant difference in the opinions of both groups. Finally, binary logistics regression was used in ascertaining the factors that significantly influenced the choice of hospitals in Ghana.

Findings

In Ghana, patients’ choice of private or public hospital was significantly influenced by service quality, word-of-mouth, type of ailment and National Health Insurance Scheme (NHIS). Patients who made choice decision based on service quality were more likely to attend a private hospital. Word-of-mouth influenced the choice of public hospitals more than private hospitals. Patients preferred visiting public hospitals for more complicated ailments such as spinal defects, HIV/AIDS, heart-related problems, etc. Patients registered under the NHIS also preferred visiting public hospital to private hospital. Although services from private hospitals were more expensive, patients were more satisfied with services provided, as compared to patients from the public hospital. Cost of service and patient satisfaction, however, did not have a statistically significant effect on the choice of hospital.

Originality/value

Most comparative studies done on private and public hospitals studied in isolation focused on service quality, customer satisfaction, national health insurance and cost of health care or a combination of them. This study, however, considered all these selection criteria and extended it by adding word-of-mouth and the type of ailments suffered. The study, thus, provided a more comprehensive hospital selection criteria. The use of logistics regression in this particular area of study was also quite unique.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 11 no. 1
Type: Research Article
ISSN: 1750-6123

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Article
Publication date: 1 March 1979

Thomas Blumenthal

An analysis of community health, its history, successes and failures, depends on an understanding of its scope, but there is little consensus as to precisely what the…

Abstract

An analysis of community health, its history, successes and failures, depends on an understanding of its scope, but there is little consensus as to precisely what the discipline entails. Some view it as a strict scientific discipline, others see it as a social movement, and still others conceive of it as a conglomerate of various disciplines. It is useful initially to identify the medical components of community health, and then to approach its interdisciplinary aspects. Community health, strictly defined, includes such fields as disease control, environmental sanitation, maternal and child care, dental health, nutrition, school health, geriatrics, occupational health, and the treatment of drug and alcohol abuse. This limited definition, though accurate, does not differentiate the field from the much older area of public health. Within community health, the disease focus of traditional public health epidemiology, the total health focus of community medicine, and the outcome focus of health services research are interconnected. Community health combines the public health concern for health issues of defined populations with the preventive therapeutic approach of clinical medicine. An emphasis on personal health care is the result of this combination. Robert Kane describes the field accurately and succinctly: “We envision community medicine as a general organizational framework which draws upon a number of disciplines for its tools. In this sense, it is an applied discipline which adopts the knowledge and skills of other areas in its effort to solve community health problems. The tools described here include community diagnosis (which draws upon such diverse fields as sociology, political science, economics, biostatistics, and epidemiology), epidemiology itself, and health services research (the application of epidemiologic techniques on analyzing the effects of medical care on health).”

Details

Collection Building, vol. 1 no. 3
Type: Research Article
ISSN: 0160-4953

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Article
Publication date: 11 May 2021

Awinaba Amoah Adongo, Jonathan Mensah Dapaah, Francess Dufie Azumah and John Onzaberigu Nachinaab

Several studies have described health-seeking behaviour within the context of various diseases, the health status and age group. However, knowledge on patient health

Abstract

Purpose

Several studies have described health-seeking behaviour within the context of various diseases, the health status and age group. However, knowledge on patient health-seeking behaviour in the use of public and private hospitals and socio-demographic characteristics in developing countries is still scarce. This paper examines the influence of socio-demographic behavioural variables on health-seeking behaviour and the use of public and private health facilities in Ghana.

Design/methodology/approach

Quantitative research approach uses the modified SERVQUAL dimension as a data collection tool. Descriptive statistics with Pearson's chi-square test were conducted to determine the relationship between socio-demographic behavioural variables and health-seeking behaviour of patients using public and private hospitals.

Findings

The results showed that there is a significant relationship between the socio-demographic characteristics (sex, marital status, education, level of income) and the health-seeking behaviour of patients in regard to the utilisation of public and private health facilities (p < 0.000).

Originality/value

There is a significant relationship between patients' socio-demographic variables and their choice and utilisation of public and private healthcare services. This information is of value to policy makers so that they have an idea on the socio-demographic behavioural variables that influence patients' health-seeking behaviour.

Details

International Journal of Sociology and Social Policy, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0144-333X

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Article
Publication date: 1 February 1992

Francesco Taroni, Daniel Z. Louis and Elaine J. Yuen

The European Community is currently experimenting with the use ofDiagnosis Related Groups (DRGs) and other patient classificationsystems. Disease Staging is a clinically…

Abstract

The European Community is currently experimenting with the use of Diagnosis Related Groups (DRGs) and other patient classification systems. Disease Staging is a clinically based classification system which focuses on the dimensions of severity of illness and can be implemented using the same data required for the DRGs. Reports a pilot study in the Emilia‐Romagna region of Italy, where data were analysed from three hospitals for patients hospitalized in 1988 with four diseases: coronary artery disease/acute myocardial infarction, cholecystitis, appendicitis, and diabetes mellitus. The same patients were classified using DRGs and Disease Staging, and the Disease Staging methodology was used to analyse issues of timeliness of hospital admission, length of stay patterns, and in‐hospital mortality rates.

Details

Journal of Management in Medicine, vol. 6 no. 2
Type: Research Article
ISSN: 0268-9235

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Book part
Publication date: 12 October 2011

Walter Schönfelder and Trond Bliksvær

Contemporary categorizations of western-style welfare states distinguish a particular pattern of organizing social security mainly found in Scandinavian countries, and…

Abstract

Contemporary categorizations of western-style welfare states distinguish a particular pattern of organizing social security mainly found in Scandinavian countries, and sometimes labeled as a “social democratic welfare regime.” This is characterized by general access of the population to a social security system organized and administered by public authorities. This categorization is widely acknowledged, but the Scandinavian “social democratic” model is rarely ever analyzed in detail.

While most health services are provided by public actors, it is often overlooked that health services in Scandinavian countries in certain fields are delivered to a substantial part by private actors. In Norwegian rehabilitation specialist health care, these private actors stand for more than 30% of all service delivery.

Based on a content analysis of publications of the Norwegian Ministry of Health and Care Services we look into the relation between public and private actors in rehabilitation and relate our findings to classifications of Scandinavian welfare states into an institutional, social democratic model.

Details

Access to Care and Factors that Impact Access, Patients as Partners in Care and Changing Roles of Health Providers
Type: Book
ISBN: 978-0-85724-716-2

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1 – 10 of over 86000