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Open Access
Article
Publication date: 5 October 2023

Maria Vincenza Ciasullo, Alexander Douglas, Emilia Romeo and Nicola Capolupo

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are…

Abstract

Purpose

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

Design/methodology/approach

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

Findings

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

Research limitations/implications

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

Practical implications

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

Originality/value

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

Details

International Journal of Quality & Reliability Management, vol. 41 no. 3
Type: Research Article
ISSN: 0265-671X

Keywords

Book part
Publication date: 29 January 2021

Eddie C. Cheung and Yiu C. Ma

This chapter attempts to study the long-term determinants of public and private healthcare expenditure in Hong Kong, by employing time series data over the period from 1990 to…

Abstract

This chapter attempts to study the long-term determinants of public and private healthcare expenditure in Hong Kong, by employing time series data over the period from 1990 to 2017. We find that income is not a determinant of either public or private spending per capita on healthcare services. Rather, a higher proportion of elderly will raise public expenditure on health and private spending even more. The share of children within the population will conversely decrease both public and private spending. Results also show that the rising density of doctors decreases both public and private per capita healthcare spending, showing that the supplier-induced demand problem is not an issue in Hong Kong.

Details

Modeling Economic Growth in Contemporary Hong Kong
Type: Book
ISBN: 978-1-83909-937-3

Keywords

Article
Publication date: 6 April 2010

Nana Owusu‐Frimpong, Sonny Nwankwo and Baba Dason

This paper aims to explore patients' satisfaction with access to treatment in both the public and private healthcare sectors in London.

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Abstract

Purpose

This paper aims to explore patients' satisfaction with access to treatment in both the public and private healthcare sectors in London.

Design/methodology/approach

Qualitative and quantitative methods were employed to determine patients' levels of satisfaction. A semi‐structured face ‐to‐face non‐probability quota sampling and a probability sample drawn from multistage cluster sampling methods were employed.

Findings

The results revealed varying access experiences among public and private care users. Public, as opposed to private, healthcare users experience unsatisfactory outcomes in relation to service climate factors (e.g. getting attention from doctors, time taken to get appointments, access to core treatment and opening hours). Overall, while women are more disadvantaged by spatial accessibility to treatment than men, both public and private healthcare users indicate major problems in accessing healthcare despite the myriad intervention strategies aimed at ameliorating the situation in both sectors. Therefore, access‐to‐care problems are significant and need to be addressed by managers and healthcare providers in order to improve the quality of service delivery and patient satisfaction. Private care users fare better than public users in obtaining medical care at short notice, having more agreeable opening hours for treatment and getting appointments for treatment with less difficulty.

Research limitations/implications

Whereas the limitation of the study was due to its small sample size, it nevertheless will stimulate insight into further academic endeavours.

Practical implications

Academics and practitioners will find the results very useful when making decisions about healthcare provisions and how they can best meet user/patient satisfaction.

Originality/value

This study is significant in drawing on the current literature on satisfaction which is usefully applied to evaluate patients' response to the quality management initiatives in the healthcare sector.

Details

International Journal of Public Sector Management, vol. 23 no. 3
Type: Research Article
ISSN: 0951-3558

Keywords

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-seeking…

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. 42 no. 5/6
Type: Research Article
ISSN: 0144-333X

Keywords

Book part
Publication date: 6 December 2017

Roberto Moro Visconti, Anna Doś and Asli Pelin Gurgun

The aim of the chapter is to compare Public–Private Partnership (PPP) healthcare investments in developed countries with those in emerging economies, analysing the sustainability…

Abstract

The aim of the chapter is to compare Public–Private Partnership (PPP) healthcare investments in developed countries with those in emerging economies, analysing the sustainability issues of health-led growth. Healthcare PPP best practices in developed nations represent a template that catching-up economies may follow with local adaptations. A comparison starts from the UK case and then examines the Turkish experience as an ideal bridge between advanced and developing countries. Healthcare investments are a primary social infrastructure, with a deep impact on poverty alleviation. Demand for the infrastructure necessary to provide healthcare services has increased substantially in developing and emerging economies due to rapid economic growth, industrialization and urbanization, while public supply is limited by budget constraints. PPP best practices provide a global benchmark (World bank, 2015b). Integrated supply and value chains and management of viability milestone improve healthcare PPP sustainability and bankability. Different legal frameworks and funding issues are not thoroughly investigated. Careful customization and local fine-tuning of best practices require further scrutiny. Homogenization of best practices improves comparison of different projects, fostering competition and easing cross-border investments, accompanied by knowledge transfer, sharing and consequent value co-creation. Best practices improve value for money, bankability and resilience of PPP investments, with potential benefits for healthcare services and quality of life. This chapter makes an innovative and comprehensive comparison of healthcare PPP projects worldwide, looking for a common denominator of value-enhancing rules and resilient pro-growth strategies.

Details

The Emerald Handbook of Public–Private Partnerships in Developing and Emerging Economies
Type: Book
ISBN: 978-1-78714-494-1

Keywords

Article
Publication date: 4 September 2017

Asma Shabbir, Shahab Alam Malik and Saquib Yusaf Janjua

The purpose of this paper is to investigate patients’ views toward the perceived service quality of public and private healthcare service providers. Determinants of healthcare

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Abstract

Purpose

The purpose of this paper is to investigate patients’ views toward the perceived service quality of public and private healthcare service providers. Determinants of healthcare service quality were compared by carrying out a GAP analysis to equate perceived and expected services and examined differences in the service quality.

Design/methodology/approach

The study sample comprises 310 inpatients of public and private healthcare service providers. Self-administered questionnaires were used along a five-point Likert scale and analyzed through the Statistical Package for Social Sciences. GAP analysis was used to observe the difference between expectations and perceived service quality.

Findings

A cross-sectional study revealed significant quality gaps between the expected and perceived services of public and private healthcare service providers; conversely patients’ expectations are not fully met in both types of hospitals. Private hospitals surpassed in terms of overall perceived service quality from their counterparts. Perceived services were found better in terms of physician medical services in public sector hospitals, while rooms and housekeeping services were found better in terms of private sector hospitals.

Practical implications

The result can be used by both public and private healthcare service providers to restructure their quality management practices which could only be possible through effective management commitment, regular patients’ feedback and translucent complaint procedures.

Originality/value

The study conceptualizes the expected and perceived hospital service quality dimensions as an eight-dimensional framework. A comparison between public and private sector hospitals is made to get a better understanding about the differences in the perceived healthcare services among two sectors. Consequences of the study will aid hospital managers and policy makers to get a fuller picture of healthcare services in order to contrive enhancement practices.

Details

International Journal of Quality & Reliability Management, vol. 34 no. 8
Type: Research Article
ISSN: 0265-671X

Keywords

Article
Publication date: 18 July 2019

Rahmat Nurcahyo, Ellia Kristiningrum and Sik Sumaedi

The purpose of this paper is to measure the efficiency of ISO 9001-certified public healthcare center in Jakarta, Indonesia and examine the impact of “re-certification“ on the…

Abstract

Purpose

The purpose of this paper is to measure the efficiency of ISO 9001-certified public healthcare center in Jakarta, Indonesia and examine the impact of “re-certification“ on the efficiency.

Design/methodology/approach

The sample of the research is 30 ISO 9001-certified district public healthcare centers in Jakarta. The data envelopment analysis (DEA) and the Man–Whitney U test were applied.

Findings

The research result showed that there is a variation in efficiency values of ISO 9001-certified public healthcare centers that this research studied. There are only 23 percent of the public healthcare centers that can be categorized as the technically efficient public healthcare center. Furthermore, this research also found that there are no significant efficiency value differences among the groups of public healthcare center based on the number of “re-certification” the center experienced.

Research limitations/implications

This research only involved ISO 9001-certified public healthcare center from Jakarta, Indonesia.

Practical implications

Registering ISO 9001 for the public healthcare center does not guarantee that the public healthcare center will have better efficiency. The government and the public healthcare center management should ensure that the ISO 9001 implementation method used by the public healthcare center is appropriate for improving the efficiency of the public healthcare center.

Originality/value

There is a lack of research that studied the efficiency of ISO 9001-certified public healthcare center. Furthermore, there is no research that investigates the effect of “re-certification“ on efficiency. This research fulfills the literature gaps.

Details

International Journal of Productivity and Performance Management, vol. 69 no. 4
Type: Research Article
ISSN: 1741-0401

Keywords

Article
Publication date: 1 March 2013

Alan Turrell

This paper explores the potential application of public value management theory to the practice of UK healthcare procurement. By conducting a literature review, key elements of…

Abstract

This paper explores the potential application of public value management theory to the practice of UK healthcare procurement. By conducting a literature review, key elements of public value theory and practice that can be applied to healthcare procurement are identified together with mechanisms that can be used in procurement to protect public values and enhance the creation of public value. These are formed into a Public Value Healthcare Procurement Framework which represents a fresh normative approach to healthcare procurement by focussing on a broader, societal view of value; by providing a blue print for procurement leaders centred around Moore's vision of “exploring” and “moral” public managers; and by promoting a public service ethos amongst all providers including the private sector.

Details

Journal of Public Procurement, vol. 13 no. 4
Type: Research Article
ISSN: 1535-0118

Book part
Publication date: 23 February 2022

Erik Bækkeskov and Peter Triantafillou

Healthcare provision in Denmark reflects some of the key principles of the welfare state. By securing relatively easy and equal access for all Danish residents regardless of…

Abstract

Healthcare provision in Denmark reflects some of the key principles of the welfare state. By securing relatively easy and equal access for all Danish residents regardless of income via general tax financing, the Danish healthcare system has strong ethical merits. All residents are entitled to comprehensive healthcare services. The Danish healthcare system is also relatively efficient. Total healthcare expenditures – including public and private – amount to 10% of GDP, above the OECD 8.8% average but well below the costs in the other Nordic countries, Germany, Switzerland and the United Stated. Notwithstanding its merits, healthcare in Denmark shares key predicaments with other OECD countries, primarily how to improve health outcomes while containing care expenditures. All of the OECD countries aim to improve population life expectancy and health quality. Yet their ageing and increasingly obese populations are exacerbating the demands on their respective healthcare systems. This chapter examines changes in how Denmark has managed these challenges. The main argument is that the healthcare system performance on managing health outcomes and costs improved remarkably from the 1990s to the early 2020s, although outcome inequalities remain. Notable changes in the system were targeted innovations in treatment procedures and expansion of municipal rehabilitation and preventive efforts, along with strict budget controls.

Details

Public Governance in Denmark
Type: Book
ISBN: 978-1-80043-712-8

Keywords

Article
Publication date: 11 February 2019

Redwanur Rahman

The purpose of this paper is to examine the factors that triggered the privatisation of Bangladesh’s health sector.

Abstract

Purpose

The purpose of this paper is to examine the factors that triggered the privatisation of Bangladesh’s health sector.

Design/methodology/approach

This study follows systematic reviews in its undertaking and is based on an extensive review of both published and unpublished documents. Different search engines and databases were used to collect the materials. The study takes into account of various research publications, journal articles, government reports, policy and planning documents, relevant press reports/articles, and reports and discussion papers from the World Health Organization, the World Bank and the Asian Development Bank.

Findings

While Bangladesh’s healthcare sector has undergone an increasing trend towards privatisation, this move has limited benefits on the overall improvement in the health of the people of Bangladesh. The public sector should remain vital, and the government must remobilise it to provide better provision of healthcare.

Research limitations/implications

The paper focusses only on the public policy aspect of privatisation in healthcare of a country.

Practical implications

The paper examines the issue of privatisation of healthcare and concludes that privatisation not only makes services more expensive, but also diminishes equity and accountability in the provision of services. The study, first, makes a spate of observations on improving public healthcare resources, which can be of value to key decision makers and stakeholders in the healthcare sector. It also discourages the move towards private sector interventions.

Originality/value

This study is an independent explanation of a country’s healthcare system. Lesson learned from this study could also be used for developing public policy in similar socio-economic contexts.

Details

International Journal of Health Care Quality Assurance, vol. 32 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

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