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We adopt a standard distributional impact methodology, based on Atkinson's cost of inequality approach, to estimate the degree of implicit redistribution created through public funding of health insurance in Canada. The first stage of the exercise is to determine the public health insurance benefits received by families of various age and composition and to add these to measured after-tax incomes. In our base case, which uses the Atkinson Mean Logarithmic Deviation as inequality index, we find that accounting for public health insurance benefits implies a reduction in inequality equivalent to 2.4% of per capita income. We then model the implications of moving to a hypothetical fully privatized system while proportionately refunding to individuals the tax revenues saved in doing so. This would give rise to a further 2.4% equivalent per capita income reduction resulting from increased inequality in the distribution of after-tax income. Thus, for this scenario, moving from public financing of health insurance in Canada to a fully privatized system implies an overall increase in inequality equivalent to a loss of 4.8% of per capita income. This corresponds to an increase of about 25% in existing inequality. Not surprisingly, the impact of publicly financed health insurance in reducing inequality is strongest for the elderly.

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.

The purpose of this paper is to show how the Turning Point Initiative to improve the health of populations by improving the USA public health system has many lessons on collaboration for governance systems.

The article synthesizes published literature outlining the results of a Robert Wood Johnson Foundation/W.K. Kellogg Foundation grant program to 21 USA states and 43 communities and relationships to administrative practice.

Turning Point's creation of a formalized network of public health partners across the USA has led to innovations in collaboration, increased system capacity, and alternative structures for improving health.

Turning Point's efficacy in community health system improvement can be mirrored in clinical governance. A major potential for improvement in clinical delivery systems is available by re‐thinking key partners, organizational structures, and system administrative capacity.

The purpose of this paper is to present the contemporary understanding and emerging structural models of organisational governance of public hospitals in order to provide evidence-based guidance to countries that are reforming their public hospital governance structures in line with best practice.

The paper uses the structural dimension of Cooper, Fusarelli and Randall’s policy model and institutional theory to review the legislative frameworks of four model countries supported by extant literature.

The paper conceptually distinguishes health system governance and organisational governance in the health system. It further visualises the emerging alternative legislative models of organisational governance and a hierarchy of governors applicable to public hospitals.

The paper provides critical knowledge for understanding organisational governance within health system governance framework and develops tools that can be used in reforming institutional mechanism of organisational governance of public hospitals.

Nations such as the USA are investing in technologies such as electronic health records in order to collect, store and transfer information across boundaries of health care, public health and research. Health information brokers such as health care providers, public health departments and university researchers function as “access points” to manage relationships between the public and the health system. The relationship between the public and health information brokers is influenced by trust; and this relationship may predict the trust that the public has in the health system as a whole, which has implications for public trust in the system, and consequently, legitimacy of involved institutions, under circumstances of health information data sharing in the future. This paper aims to discuss these issues.

In this study, the authors aimed to examine characteristics of trustors (i.e. the public) that predict trust in health information brokers; and further, to identify the factors that influence trust in brokers that also predict system trust. The authors developed a survey that was administered to US respondents in 2014 using GfK’s nationally representative sample, with a final sample of 1,011 participants and conducted ordinary least squares regression for data analyses.

Results suggest that health care providers are the most trusted information brokers of those examined. Beliefs about medical deceptive behavior were negatively associated with trust in each of the information brokers examined; however, psychosocial factors were significantly associated with trust in brokers, suggesting that individual attitudes and beliefs are influential on trust in brokers. Positive views of information sharing and the expectation of benefits of information sharing for health outcomes and health care quality are associated with system trust.

This study suggests that demonstrating the benefits and value of information sharing could be beneficial for building public trust in the health system; however, trust in brokers of information are variable across the public; that is, knowledge, attitudes and beliefs are associated with the level of trust different individuals have in various health information brokers – suggesting that the need for a personalized approach to building trust.

This paper aims to use systems mapping as a tool to develop an organisation-wide approach to public mental health to inform strategic direction within a national public health agency.

Two workshops were facilitated with internal staff from a wide range of public health policy teams working in small groups to produce paper-based maps. These were collated and refined by the project team and digitised.

The approach engaged a range of teams in forming a shared understanding and producing a complex system map of the influences on population mental health and well-being, where current policy initiatives were addressing them and what the gaps and priorities were. Participants valued the approach which led to further study and organisational commitment to the whole system working as part of national public mental health strategy.

The approach was limited to internal stakeholders and wider engagement with other sectors and community members would help further the application of complex system approaches to public mental health.

It was a valuable process for developing a whole-organisation approach and stimulating thinking and practice in complex system approaches. The paper provides a practical example of how to apply systems mapping and its benefits for organising public mental health practice.

This paper aims to investigate the market access (MA) of ethical drugs, the underlying public-private interaction (PPI) between pharmaceutical companies and public actors, and the implications for the sustainability of the health system.

A qualitative interpretivist approach was selected. Interviews were carried out as the primary method of data collection: 27 interviews were conducted with 13 key informants from the pharmaceutical industry.

The perspective of MA evolves from formal negotiation with the public actor at various levels to PPI, which should include aspects of interactions with other actors in the network. Conceptualization in these terms is fundamental because it allows an understanding of the implications in terms of the sustainability of the health system.

The paper discusses MA by highlighting the shift from a “market access as formal negotiation” perspective to a “public-private interaction for market access” perspective, in which the focus is on the content of the interaction and the representation of the network of relevant actors for MA. It contributes to the debate on the sustainability of health systems by suggesting the adoption of a medium-to-long-term approach to economic and social sustainability based on PPI; it adopts an industrial marketing approach and contributes to the recent debate on PPI.

The purpose of this paper is to study the managing of emergencies pertinent to public health which is critical to the well‐being of a society; as such, the management mechanisms employed should be of great interest and significance for research.

This paper first relies on extensive literature to describe the mechanism used in the USA from three aspects – organizational structure, management system, and logistics network. For the purpose of comparison, the Chinese version of the mechanism is presented from the same three aspects. The two management systems are then compared both qualitatively and quantitatively.

Deficient areas in Chinese public‐health management mechanism as well as challenging issues associated with supply chain design and coordination for emergency supplies in the context of large‐scale public health emergencies with low frequency but catastrophic impacts are found. Specifically, the following three important research problems are revealed from the comparative study: how to establish an efficient organizational structure that incorporates all the relevant entities in public‐health emergency management? How to establish an information system for emergency management that integrates disease surveillance, control, and prevention? How to design an efficient and cost‐effective logistics network to ensure prompt and sufficient delivery of emergency supplies?

To date, this research has been the first of its kind that compares two countries' emergency management systems in the context of public health management.

This chapter introduces readers to a complex adaptive systems approach for integrating research on genes, behavior, and social structures/institutions. Until recently, scientists have resorted to reductionism as a decoding and epistemological strategy for understanding human health. The complex bonds among health’s biological, behavioral, and social dimensions, however, cannot be fully grasped with reductionist schemas. Moreover, because reducing and simplifying can lead to incomplete understanding of phenomena, the resulting deficient knowledge has the potential to be harmful.

To achieve its purpose, this primer will: (1) introduce fundamental notions from complexity science, useful for inquiry and practice integrating research on genes, behavior, and social structures; (2) outline selected methodological strategies employed in studying complex adaptive/dynamic systems; (3) address the question, “Specifically, how can a dynamic systems approach be helpful for integrating research on genes, behavior, and social structures/institutions, to improve the public’s health?”; and (4) provide examples of studies currently deploying a complexity perspective.

The originality/value of this primer rests in its critique of the research status quo and the proposition of an alternative lens for integrating genomic, biomedical, and sociological research to improve the public’s health. The topic of complex adaptive/dynamic systems has begun to flourish within sociology, medicine, and public health, but many researchers lack exposure to the topic’s basic notions and applications.