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This study focuses on a particular type of public organization characterized by weak boundaries and strong informal relationships, elements that have assisted in driving the reform of an entire national public management system. The case is the Public Healthcare System of the Southern Italy in the period beginning in the early 1990s through the beginning of the new millennium, with particular emphasis on the Sicilian region, selected since it represents an extreme case of informal networks that affect organizational boundaries and governance functions.

This paper reports on an action research study based optimization project related to healthcare IT implemented on the Faroe Islands. The aims were to study what constitutes value in the public healthcare setting by applying and activating existing resources in the organization, hence answering the overall research question: How can a resource-based view (RBV) improve benefits management (BM) practices?

By applying a RBV to findings from an action research study of an optimization project of an integrated health information system (HIS), a framework of capabilities needed in a public HIS setting to create value was developed.

The theoretical contribution is a framework explaining how BM practices and, hence, value can be interrelated in a public healthcare IT system.

The study shows the need for academic IT professionals to structure and facilitate value generation, especially in the form of creating an innovative and learning environment in the form of an action research based project.

This study suggests which actors should be motivated and developed in order to ensure value in healthcare IT projects. Having value creation in mind, the model could have potentially broad applicability in a variety of healthcare IT settings.

The findings leads to better usage of public healthcare resources.

The present research studies real problems in a real setting, thus providing distinct ideas on how to improve public value creation by direct engagement of researchers.

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.

The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada.

In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a “double blind, double scored” methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management – operations, performance monitoring, targets and people management.

The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most.

This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services.

This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of management practices in the Australian public healthcare systems of Queensland and NSW.

Given the efficacy of a robust public healthcare system in handling public health emergencies, the rapid rate of COVID-19 pandemic infection in early-hit (advanced) countries with competent healthcare system is intriguing. The popular public health argument supports the strengthening of the healthcare system as a significant response strategy to minimize infection. Hence, this paper examines the catalysts that exacerbated the pandemic’s rapid spread in these countries despite the sound state of their healthcare system. Also, it assesses the condition of Nigerian public healthcare system in the lights of the novel COVID-19 pandemic and suggests the need for improvement and effective functioning.

This paper uses a documentary approach to establish the authors’ opinion on the subject matter under investigation.

Factors such as climate, temperature, and humidity levels played a key role in infection in the winter of 2020. These factors facilitated for the pandemic’s rapid spread in advanced countries. In peripheral countries like Nigeria, the public healthcare system is burdened by a lack of funding, an insufficiency in welfare and training for healthcare staff and facilities and other operational challenges. Hence, the effective management of COVID-19 outbreak in Nigeria relative to advanced countries was hindered by the inadequacies mentioned above.

This paper provides an understanding on the condition of public healthcare system in peripheral nations in relation to the healthcare system advisories from the World Health Organization (WHO) in the context of handling the pandemic outbreak. Also, it explains the catalysts that heightened the pandemic’s rapid spread in advanced countries despite the higher capacity of their healthcare system to manage health emergencies.

This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the strategies and contextual influences to attain patient recovery flexibility.

This paper uses a case study method based on a semi-structured interview with healthcare professionals, observations and informal discussions.

In the present study, several dimensions of patient recovery flexibility are reported. Different internal and external strategies to exhibit patient recovery flexibility, as well as two contextual influences, are identified. An integrative framework is developed to establish the relationship of patient recovery flexibility with service experience in public healthcare.

The study was conducted in a public healthcare setting in India. The sample size for the semi-structured interview was limited to healthcare professionals, and the patient’s perspective is missing.

This paper contributes to the growing need for patient recovery flexibility as a strategy in the public healthcare delivery system. It offers new insights to address the gap in the literature regarding the linkage of patient recovery flexibility and service experience. The study provides an integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and the impact on the service experience. The framework and propositions presented in the study will guide future research that is needed in this area. This study provides an overview to shape and redesign the after-service support from a flexibility perspective in public healthcare for the improved service experience.

The purpose of this paper is to analyse the relationship between outpatient satisfaction and the five constructs of healthcare projects’ service quality in Pakistan using Deng’s grey incidence analysis (GIA) model, absolute degree GIA model (ADGIA), a novel second synthetic degree GIA (SSDGIA) model and two approaches of decision-making under uncertainty.

The study proposes a new synthetic GIA model and demonstrates its feasibility on data (N=221) collected from both public and private sector healthcare projects of Punjab, the most populous province of Pakistan, using a self-administered questionnaire developed using the original SERVQUAL approach.

The results of decision analysis approach indicated that outpatients’ satisfaction from the private sector healthcare projects is higher as compared to the public healthcare projects’. The results from the proposed model revealed that tangibility and reliability play an important role in shaping the patient satisfaction in the public and private sectors, respectively.

The study is pioneer in evaluating a healthcare system’s service quality using grey system theory. The study proposes the SSDGIA model as a novel method to evaluate parameters comprehensively based on their mutual association (given by absolute degree of grey incidence) and inter-dependencies (given by Deng’s degree of grey incidence), and tests the new model in the given scenario. The study is novel in terms of its analysis of data and modelling. The study also proposes a comprehensive structure of the healthcare delivery system of Pakistan.

A key question in the provision of public health concerns how that provision is governed. The purpose of this paper is to examine the governance structure of a public health board and its perceived impact on the efficacy of clinical operations.

Structural issues examined the level of centralisation and public participation, and whether governance should occur through elected boards or appointed managers. These issues were examined through multiple lenses. First was the intention of the structure, examining the issues identified by parliament when the new structure was created. Second, the activities of the board were examined through an analysis of board meetings. Finally, hospital clinicians were surveyed through semi-structured interviews with both quantitative and qualitative questioning.

A contradiction was revealed between intention, perception and actual activities. This raises concerns over whether the public are significantly informed to elect the best-skilled appointees to governance positions.

This research holds implications for selecting governance structures of public health providers.

Few studies have looked at the role of a publicly elected healthcare governance structure from the perspective of the clinicians. Hence, this study contributes to the literature on healthcare structure and its impact on clinical operations, by including a clinician’s perspective. However, this paper goes beyond the survey and also considers the intention of the structure as proposed by parliament, and board activities or what the board actually does. This enables a comparison of intention with outcomes and perception of those outcomes.

Scientific description of the organization and management of a temporary large scale healthcare (T-LSHc) vaccination clinic and evidence-based guidance for future temporary healthcare (T-Hc) services.

Mixed-methods rapid feedback case study, using interviews, document analysis and quantitative data, with both data collection and analysis guided by a research-informed systems program theory of the clinic.

Private contractors were not willing to bid for contracts to set up and close a T-LSHc vaccination clinic in 2022, although they had done so earlier in the year. The public health system was able successfully to set up and run the clinic itself for 2 months, serving 3,000 people a day at its peak. Part of the success was because a dedicated unit to set up and run T-Hc services had been created in 2020. The Stockholm organization model differed from the Milan model by using information technology to reduce the need for a large number of on-site doctors.

There may be recall bias in interview data as interviews were carried out four months after the closing of the clinic. The conclusions apply to clinically simple but managerially complex T-Hc services but are limited to public healthcare systems operating in a similar context to that of the case study service. The study contributes to the new science of healthcare crisis organization and management and fills gaps in knowledge in disaster medicine for enduring and fluctuating health crises. The findings show the importance of a capacity to establish and manage T-Hc, and of the specialist management and HIT competence that health systems will need to build to meet the crises that threaten our health, both now and in the future.

Public healthcare systems can provide clinically simple and managerially complex T-Hc services quickly and successfully if they have experience and capacity to plan and set up such services, skilled operational managers respected by staff, staff who can be redeployed, and suitable health information technology.

The need for healthcare services to respond to crises is likely to increase in the future. Information for creating the service may be limited at first and changing. The exact nature of the health threat may be uncertain, as may the demand and needs of subpopulations and individuals. The study findings can help to respond quickly to reduce morbidity illness and death through creating and organizing temporary large-scale public healthcare services when existing services cannot be reorganized to meet the scale of the need.

This article is the first detailed empirical description and analysis of a large-scale temporary healthcare service operated by the primary care division of an integrated public healthcare system, with research informed guidance for future services of this type in similar contexts. This article compares two organization models of T-LSHc services, and contributes to an emerging subdiscipline of the organization and management of disaster and crisis healthcare.

The purpose of this paper is to explore how and why information and communication technologies (ICT) are enrolled in the Indian healthcare sector for reasons over and above perceived efficiency gains.

The paper explores qualitative field data collected in the Indian states of Karnataka and Andhra Pradesh, and the city of New Delhi from an epistemological perspective of interpretivism. New institutional theory is employed to illustrate the mythical and ceremonial roles that ICT for development play in legitimizing development initiatives.

The analysis challenges the simplistic view that implementing health management information systems will translate directly to efficiency gains.

This paper furthers the theoretical understanding of how ICT, as social and material phenomena, function empirically beyond instruments of technical rationality. One limitation of the research is the relatively short duration of the fieldwork. A wider scope in the metrics used to evaluate success in development initiatives that implement ICT is called for.

Practical implications of this paper focus on the need to move away from simple deterministic visions of ICT for development towards an approach based on acknowledging outcome indeterminacy with regard to the consequences of ICT implementation in the Indian healthcare sector, and thus the need for genuine feedback loops.

This paper will be valuable to institutional and information systems theorists, and development practitioners. A framework is provided to unpack the institutional context that drives some of the inefficiency in the Indian healthcare sector.