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1 – 10 of over 31000Utkarsh Shrivastava, Bernard Han, Mohammad Daneshvar Kakhki and J. Michael Tarn
Health Information Exchange (HIE) is essential for the efficient and cost-effective delivery of health-care services. The provider’s administrative structure and external…
Abstract
Purpose
Health Information Exchange (HIE) is essential for the efficient and cost-effective delivery of health-care services. The provider’s administrative structure and external environment can substantially influence adopting technologies involving inter-organizational linkages, such as HIE. Using the theoretical lens of institutional theory, this study aims to compare how public and private hospitals' engagement in HIE is influenced by corruption and government online services or e-government usage.
Design/methodology/approach
The study uses the positivist research design of secondary data analysis to test the six hypotheses proposed. Data from multiple third-party reliable sources, including the European Commission and World Bank, are combined into the final dataset consisting of observations from 1,442 hospitals across 30 countries in Europe. A multilevel modeling approach is used to associate country and hospital-level variables and test the hypothesis.
Findings
The study finds that, on average, a 10% increase in corruption leads to a 6.3% decrease, while a 10% increase in e-government leads to a 7% increase in the probability of HIE engagement for a hospital. The negative impact of corruption on average is 18% more in public than private hospitals, while the positive impact of e-government is 75% stronger in public in comparison to private hospitals. The study also finds that HIE engagements in health systems with predominantly public hospitals are more sensitive to corruption and e-government.
Originality/value
To the best of the authors’ knowledge, the study is one of the first to use the institutional view to test the influence of government actions and public providers' concentration on HIE engagement. The comparison of public and private institutions enriches our understanding of promoters and inhibitors of HIE.
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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.
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Andrew Munthopa Lipunga, Betchani M.H. Tchereni and Rhoda Cythia Bakuwa
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Originality/value
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.
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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…
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.
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Julie Froud, Colin Haslam, Sukhdev Johal, Jean Shaoul and Karel Williams
Using the example of capital charging in UK hospitals, this paper shows how new public policy initiatives are justified through forms of persuasion without numbers and can be…
Abstract
Using the example of capital charging in UK hospitals, this paper shows how new public policy initiatives are justified through forms of persuasion without numbers and can be challenged with empirics. A reading of official and academic texts shows how the official problem definition focuses on poor asset utilisation. Hospital accounts are then reworked to show that, although poor asset utilisation was never a major problem, the introduction of capital charges could disrupt service provision. The conclusion is that the operation of NHS hospitals should be understood in terms of distributive conflict, rather than inefficiency. Through practical demonstration, the authors of this article aim to encourage accounting researchers to use numbers to challenge public policy definitions.
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Jayesh P. Aagja and Renuka Garg
The purpose of this paper is to develop a scale for measuring perceived service quality for public hospitals from the user's (patient's) perspective. The objective is to measure…
Abstract
Purpose
The purpose of this paper is to develop a scale for measuring perceived service quality for public hospitals from the user's (patient's) perspective. The objective is to measure perceived service quality of public hospitals.
Design/methodology/approach
Standard scale development research procedure recommended by experts was followed. First, literature review of studies to measure service quality was undertaken. Later, Delphi method (two iterations) was used. Interviews were conducted of experts and customers for understanding and generating items for perceived service quality for public hospitals. A survey was then undertaken first for development of the scale and later for validation purpose.
Findings
A reliable and valid scale called public hospital service quality (PubHosQual) is developed to measure the five dimensions of hospital service quality: admission, medical service, overall service, discharge process, and social responsibility.
Research limitations/implications
Since, this study was conducted in India only, the generalizability of the PubHosQual scale has to be tested in other countries.
Practical implications
The proposed scale PubHosQual in this study could be used as a diagnostic tool to identity areas where specific improvements are needed, and to pinpoint aspects of the hospital's services that require modification. The paper is an attempt to develop an instrument to incorporate the “voice of the customer.”
Originality/value
Most relevant studies about perceived service quality for public hospitals either do not have stable factor structure or are relying on generic SERVQUAL scale to measure service quality. The new scale fills the gap of absence of a validated scale to measure perceived service quality for public hospitals.
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Kun Wang, Yongjian Ke, Tingting Liu and Shankar Sankaran
The purpose of this paper is to present evidence to the heated debate “whether Public-Private Partnership (PPP) model should be introduced into the hospitals” and, if so, how to…
Abstract
Purpose
The purpose of this paper is to present evidence to the heated debate “whether Public-Private Partnership (PPP) model should be introduced into the hospitals” and, if so, how to promote the social sustainability of such PPP projects.
Design/methodology/approach
This paper has established an analytical framework to analyse the social sustainability of PPP projects. Using content analysis method, a single case study was carried out on the Northern Beaches Hospital in Sydney, Australia.
Findings
The results show that there are many problems related to social sustainability in the project, due to which employees and patients were exposed to most of them. Some recommendations are provided, including to strengthen the supervision of the project, provide sufficient information, establish communication channels and stakeholder participation, improve hospital policies and procedures, and strengthen government support.
Practical implications
This paper can provide guidance for the stakeholders in a partnership, including the public and private sectors, to analyse the social sustainability implications, and then plan and implement hospital PPP projects to achieve social sustainability goals. Meanwhile, it can also provide important reference for the employees, patients, local community and society to assess social sustainability issues, and provide relevant inputs to inform decision-makers in the development, delivery and management of hospital projects.
Originality/value
The research will contribute to knowledge of social sustainability of hospital PPP projects. The proposed analytical framework can be used to analyse and assess the social sustainability of such projects from the perspective of stakeholders.
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Rocio Rodriguez, Göran Svensson and David Eriksson
The purpose of this paper is to examine the logic and differentiators of organizational positioning and planning of sustainability initiatives between private and public…
Abstract
Purpose
The purpose of this paper is to examine the logic and differentiators of organizational positioning and planning of sustainability initiatives between private and public organizations in the healthcare industry. Sustainability initiatives refer to organizations’ economic, social and environmental actions.
Design/methodology/approach
This study is based on an inductive approach judgmental sampling and in-depth interviews of executives at private and public hospitals in Spain have been used. Data were collected from the directors of communication at private hospitals, and from the executive in charge of corporate social responsibility in public hospitals. An empirical discourse analysis is used.
Findings
The positioning and planning of sustainability initiatives differs between private and public hospitals. The former consider sustainability as an option that is required mainly for social reasons, a bottom-up positioning and planning. It emerges merely spontaneously within the organization, while the sustainability initiatives in public hospitals are compulsory. They are imposed by the healthcare system within which the public hospital, operates and constitutes a top-down positioning and planning that is structured to accomplish set sustainability goals.
Research limitations/implications
A limitation of this study is that it is undertaken exclusively in Spanish organizations from one industry. This study differs from previous ones in terms of exploring the positioning and planning of the sustainability initiatives, which focus on the organizational logic of such sustainability initiatives. There are both common denominators and differentiators between private and public hospitals.
Practical implications
The logic of determining the positioning and planning of the sustainability initiatives is mainly about satisfying organizational needs and societal demands. Nowadays, organizations tend to engage in sustainability initiatives, so it is essential to understand the logic of how organizations position and plan such efforts.
Originality/value
This study investigates the path that follows sustainability initiatives in public and private organizations. It reports mainly differentiators between private and public organizations. It also contributes to explaining the organizational reasoning as to why companies make decisions about sustainability initiatives, an issue which has not been addressed sufficiently in existing theory studies.
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Sineenart Krichanchai and Bart L. MacCarthy
The purpose of this paper is to investigate vendor managed inventory (VMI) for the supply of medicines between distributors and hospitals to identify factors that may affect VMI…
Abstract
Purpose
The purpose of this paper is to investigate vendor managed inventory (VMI) for the supply of medicines between distributors and hospitals to identify factors that may affect VMI adoption.
Design/methodology/approach
Two contrasting VMI initiatives involving five organizations (three hospitals, one distributor and one manufacturer/supplier) are studied. A case study method with semi-structured interviews is used with triangulation in data collection, site visits and document analysis to enhance reliability and validity. The cases are analyzed and compared with respect to hospital, supplier, product and supply chain integration characteristics.
Findings
A successful public sector VMI initiative and an unsuccessful private sector VMI initiative are identified. The public sector supplier focuses on improving service level while the private sector supplier seeks to strengthen relationships with a key customer. Hospital characteristics, including type of hospital, top management perspectives and the hospital’s willingness to share information, are critical in decisions on VMI initiation or termination. Relatively stable demand products are preferred for a VMI approach. Hospitals may perceive risks in VMI adoption for medicines as it involves relinquishing control of critical supplies and may result in “lock-in” with a particular supplier.
Research limitations/implications
The cases have been conducted in one country, which may affect generalization of the findings. Wider empirical evidence from other countries in both developed and less developed regions will be beneficial.
Practical implications
VMI is advocated as being beneficial in many supply contexts. However, it is challenging to implement. The study identifies factors that affect the adoption of VMI for hospital pharmaceuticals and provides guidance on initiating VMI in a hospital context.
Social implications
The potential for VMI in public health projects to enable greater access to critical medicines is highlighted.
Originality/value
The paper provides supply side and demand side perspectives on VMI adoption in an important sector. It highlights the need for greater understanding of the perceived and actual risks in VMI from the perspective of both the hospital and the supplier and for much clearer advice on which pharmaceutical products are appropriate for VMI control in a hospital context.
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Stephen Oduro, Kwamena Minta Nyarku and Rotimi A. Gbadeyan
Integrating the social exchange and resource dependency theories, the study aims to comparatively examine the supplier relationship management (SRM) dimensions and organizational…
Abstract
Purpose
Integrating the social exchange and resource dependency theories, the study aims to comparatively examine the supplier relationship management (SRM) dimensions and organizational performance links of private and public hospitals in Ghana.
Design/methodology/approach
Comparative in nature; employing a quantitative approach; and using simple random and convenience sampling techniques, the study tested the proposed hypotheses using structural equation model-partial least square based on 205 usable questionnaires. Partial least square-multigroup analysis (PLS-MGA) was performed to test the significance of the difference in the parameters between the two samples: private and public hospitals in Ghana.
Findings
The dimensions of SRM (communication, cooperation, trust, atmosphere and adaptation) have a significant, positive impact on private hospitals’ performance in Ghana. Similarly, communication and trust were found to be positively and significantly correlated to public hospitals’ performance. In contrast, cooperation, atmosphere and adaptation dimensions showed no significant, positive effect on public hospitals’ performance. PLS-MGA disclosed that these observed differences in the findings between the private and public hospitals in Ghana are statistically significant.
Research limitations/implications
The findings of the study, while limited to hospitals in Ghana, are likely to be relevant in other emerging economies for effective and enhanced supply chain relationship management.
Practical implications
The findings provide pragmatic insights for marketing practitioners and organizational leaders of hospitals about the significance of SRM dimensions in today’s globalized marketplace, and how to nurture them to enhance organizational performance.
Originality/value
The value of the study lies in the examination of the relationship between SRM and organizational performance in the health sector by comparing private and public hospitals in an emerging economy context.
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