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1 – 10 of over 5000Hanna Komulainen, Satu Nätti, Saila Saraniemi and Pauliina Ulkuniemi
Recent literature within public service logic has called for more explicit conceptualisation of customer value in public services. This study aims to fill this gap by examining…
Abstract
Purpose
Recent literature within public service logic has called for more explicit conceptualisation of customer value in public services. This study aims to fill this gap by examining how the customer value approach can be applied in the management of public health care services.
Design/methodology/approach
This study is a qualitative case study of management of public health care services in Finland. The authors interviewed 17 regional health care service developers and analyzed the interview data using thematic analysis.
Findings
The study suggests five propositions for applying customer value approach from the marketing literature in public health care service management. The study enables a deeper understanding of customer value creation in this context and improvement of public health care services.
Originality/value
This study contributes to the public management research in general and public service logic research in particular by suggesting what constitutes customer value in public health care services.
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Mark Taylor and Richard Kirkham
A policy of surveillance which interferes with the fundamental right to a private life requires credible justification and a supportive evidence base. The authority for such…
Abstract
A policy of surveillance which interferes with the fundamental right to a private life requires credible justification and a supportive evidence base. The authority for such interference should be clearly detailed in law, overseen by a transparent process and not left to the vagaries of administrative discretion. If a state surveils those it governs and claims the interference to be in the public interest, then the evidence base on which that claim stands and the operative conception of public interest should be subject to critical examination. Unfortunately, there is an inconsistency in the regulatory burden associated with access to confidential patient information for non-health-related surveillance purposes and access for health-related surveillance or research purposes. This inconsistency represents a systemic weakness to inform or challenge an evidence-based policy of non-health-related surveillance. This inconsistency is unjustified and undermines the qualities recognised to be necessary to maintain a trustworthy confidential public health service. Taking the withdrawn Memorandum of Understanding (MoU) between NHS Digital and the Home Office as a worked example, this chapter demonstrates how the capacity of the law to constrain the arbitrary or unwarranted exercise of power through judicial review is not sufficient to level the playing field. The authors recommend ‘levelling up’ in procedural oversight, and adopting independent mechanisms equivalent to those adopted for establishing the operative conceptions of public interest in the context of health research to non-health-related surveillance purposes.
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Chanapong Rojanaworarit and Sarah El Bouzaidi
This article analyzes deficiencies in public health services for international migrant workers (IMWs) during the COVID-19 pandemic and provides a policy brief for improvement of…
Abstract
Purpose
This article analyzes deficiencies in public health services for international migrant workers (IMWs) during the COVID-19 pandemic and provides a policy brief for improvement of the public health system.
Design/methodology/approach
A COVID-19 outbreak that initially clustered in IMWs and further contributed to the resurgence of the disease across Thailand in December 2020 was analyzed to address the deficiencies in public health services based on the framework of the 10 Essential Public Health Services (EPHS). The EPHS framework was also applied to develop policy options and recommendations in the subsequent policy brief.
Findings
This outbreak unveiled unique challenges that make IMWs more vulnerable to COVID-19. The public health system, challenged by the COVID-19 outbreak among IMWs, manifested deficiencies in the planning and implementation of all essential services. Delayed detection of the outbreak along with the lack of policy accommodating undocumented IMWs and the lack of equitable access to testing and treatment for COVID-19 resulted in the transmission of the disease that harmed the public at large.
Originality/value
The comprehensive analysis of the deficiencies in public health services for IMWs enabled a clear description of problems that could be further prioritized by relevant stakeholders. The policy brief provides policymakers with evidence-based recommendations for improving public health services for IMWs during the COVID-19 pandemic and beyond.
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Yee-man Tsui and Ben Y.F. Fong
The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial…
Abstract
Purpose
The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.
Design/methodology/approach
The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.
Findings
The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.
Originality/value
The over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals.
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James Brackley, Penelope Tuck and Mark Exworthy
This paper examines the contested value of healthy life and wellbeing in a context of severe austerity, exploring how the value of “Public Health” is constructed through and with…
Abstract
Purpose
This paper examines the contested value of healthy life and wellbeing in a context of severe austerity, exploring how the value of “Public Health” is constructed through and with material-discursive practices and accounting representations. It seeks to explore the political and ethical implications of constructing the valuable through a shared consensus over the “facts” when addressing complex, multi-agency problems with long time horizons and outcomes that are not always easily quantifiable.
Design/methodology/approach
The theorisation, drawing on science and technology studies (STS) scholars and Karen Barad's (2007) agential realism, opens up the analysis to the performativity of both material and discursive practices in the period following a major re-organisation of activity. The study investigates two case authorities in England and the national regulator through interviews, observations and documentary analysis.
Findings
The paper demonstrates the deeply ethical and political entanglements of accounting representations as objectivity, consensus and collective action are constructed and resisted in practice. It goes on to demonstrate the practical challenges of constructing “alternative accounts” and “intelligent accountabilities” through times of austerity towards a shared sense of public value and suggests austerity measures make such aims both more challenging and all the more essential.
Originality/value
Few studies in the accounting literature have explored the full complexity of valuation practices in non-market settings, particularly in a public sector context; this paper, therefore, extends familiar conceptual vocabulary of STS inspired research to further explore how value(s), ethics and identity all play a crucial role in making things valuable.
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Ntibaneng Hunadi Maleka and Walter Matli
The purpose of this study is to provide current state of knowledge on how the COVID-19 emergency situation necessitated the behaviour influencing use and acceptance of telehealth…
Abstract
Purpose
The purpose of this study is to provide current state of knowledge on how the COVID-19 emergency situation necessitated the behaviour influencing use and acceptance of telehealth. This study interlinks the health belief model (HBM) and the unified theory of acceptance and use of technology (UTAUT) to highlight the challenges and opportunities as a result of the COVID-19 pandemic in the public health sector.
Design/methodology/approach
This study used three online databases (Emerald publishing, Science Direct and Taylor and Francis) that enabled the authors to access electronic journal articles. Search strategy was used to extract articles based on the relevance of this study.
Findings
The key findings from this study suggested that the COVID-19 emergency forced health-care workers and their patients to rapidly use and rely on telehealth to reduce the rate of COVID-19 transmissions. The key benefits of telehealth use highlighted an expansive cost effective and convenient access to health-care services irrespective of geographical local and levels of physical impairment. Moreover, telehealth inhibited in person human interaction, which was perceived as impersonal and not ideal for new patient consultations. The barriers outweighed the benefits; as a result, it is unlikely that there will be a wide use of telehealth beyond the COVID-19 emergency situation.
Practical implications
The research findings are limited to discussions drawn from available secondary data. The criteria within telehealth for policymakers to note the technology acceptance and use for both health-care and outpatient stakeholders and their health seeking behaviour. Health-care sectors (private and public) and government need to understand enablers of effective telehealth in policymaking to ease the barriers during an emergency situation like a pandemic.
Originality/value
This study contributes to the emerging literature on how COVID-19 pandemic has disrupted and accelerated telehealth by extending both the UTAUT and HBM theories. This study is expected to contribute and expand literature on telehealth during emergency situations, given the novice nature of COVID-19 and limited literature surrounding it.
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Often linked to the New Public Management (NPM) doctrines, agencification has been on the priority list of policy makers for over two decades. This article proposes an analysis of…
Abstract
Purpose
Often linked to the New Public Management (NPM) doctrines, agencification has been on the priority list of policy makers for over two decades. This article proposes an analysis of the role of agencies in the French health system and the impact of government agency reform on physicians and the public.
Design/methodology/approach
The research analyzes the perceived implementation of a re-concentration of decision-making powers within public agencies as the declared goal of agencification at the French health care system, specifically primary care providers and hospitals. The assessment relies on secondary sources from ministerial bodies such as the Ministry of Health and Social Affairs, the Ministry of Labor, the Social Security and the General Accounting Office, and specialized French technical agencies.
Findings
Decentralization in France and the subsequent rise of public health care agencies had outcomes below expectations. Hence, a re-concentration of decision-making powers within the larger Regional Health Agencies; a streamlining of the public administration; and a re-appropriation of decision-making powers by the Ministry of Health are needed. The monitoring of health providers allows central health authorities to govern at a distance.
Originality/value
The analysis of health care agencies in France and of their use of efficiency-enhancing techniques may trigger a change of values within the medical profession.
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Floriana Fusco, Marta Marsilio and Chiara Guglielmetti
Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have…
Abstract
Purpose
Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.
Design/methodology/approach
A structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.
Findings
This study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.
Research limitations/implications
This study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.
Practical implications
The framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.
Originality/value
This is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.
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Mitch Blair, Mariana Miranda Autran Sampaio, Michael Rigby and Denise Alexander
The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be…
Abstract
The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.
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Preecha Suvarnathong, Teeradej Chai-Aroon, Uthaithip Jiawiwatkul and Pasakorn Intoo-Marn
The purpose of this study was to investigate the provincial-level systems and mechanisms to develop health volunteers to improve the health of the immigrant workforce in Thailand.
Abstract
Purpose
The purpose of this study was to investigate the provincial-level systems and mechanisms to develop health volunteers to improve the health of the immigrant workforce in Thailand.
Design/methodology/approach
This qualitative study obtained data from document research, in-depth interviews with 58 people involved at policy and provincial levels working to develop health volunteers to improve the health of the immigrant workforce. Data were collected from May–October 2017; then the content of the conceptual framework was analyzed, the research objectives were examined and summary and induction analysis interpreted data from documents, observations and interviews.
Findings
Thailand has four systems for developing health volunteers to improve the health of the immigrant workforce: recruitment, training and knowledge management, welfare and motivational and financial and other supportive resources. Development is driven through the mechanisms of the Provincial Public Health Office with Non Governmental Organizations (NGOs) and network partners. The health volunteer development exhibits two patterns: developing migrant workers to become migrant health volunteers and developing village health volunteers to perform health care for the immigrant workforce. All development patterns mainly rely upon the regular operating budget, which is often inadequate. Frequently, some provinces make attempts to seek other funding sources. In fact, health volunteer development is subjected to local authorities of the four provinces whose systems and mechanisms of development differ from one another.
Originality/value
The findings from this study could help develop health volunteers to significantly improve the health of the immigrant workforce in the Thai health service system.
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