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1 – 10 of over 24000Asma 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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Laila Nordstrand Berg and Rómulo Pinheiro
In this study, we are addressing changes in managerial logics after the introduction of New Public Management (NPM)-reforms in two public sectors in Norway, namely the hospital…
Abstract
In this study, we are addressing changes in managerial logics after the introduction of New Public Management (NPM)-reforms in two public sectors in Norway, namely the hospital and the university sectors. These sectors were previously dominated by professional and political logic in management, and the focus is on professionals in managerial positions. We are asking: How do professionals in managerial positions across universities and hospitals mediate between previous and newly introduced logics in management after NPM-reforms? We have chosen to compare changes in management across the hospital and the university sectors. Both sectors are largely publicly owned and dominated by professions, but their mission differs. The empirical material comprises interviews with formal leaders from dissimilar professional backgrounds, at different levels in the organisations in two cases. The findings show that management influenced by the market logic has been introduced, but in a hybrid version. The professional logic has however not been left behind, but expanded and supplied by a neo-bureaucratic logic. Leadership is functioning as a ‘catalyst’ to handle the different logics. The originality of this paper is a comparison of management in health care and higher education related to a model of hybrid management.
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Prior studies on the interactive effects of performance evaluative style and budgetary participation on managers' budgetary performance have overlooked several important issues…
Abstract
Prior studies on the interactive effects of performance evaluative style and budgetary participation on managers' budgetary performance have overlooked several important issues. First, the moderating effects of organisational commitment have largely been overlooked. Since managers, who are highly committed to their organisations, are likely to pursue their organizations' goals much more intensely than managers who are not committed to their organisations, the effects of performance evaluative style and budgetary participation on the budgetary performance of these two groups of managers are likely to differ. Second, prior studies in this research area have concentrated mainly on the manufacturing sector. The services sectors have received relatively little attention. Third, differences between privately owned service organisations and publicly funded service organisations and their effects on performance have also not been considered. To address these gaps in the literature, this study investigates the three‐way interaction between reliance on financial measures for performance evaluation, budgetary participation and organisational commitment affecting budgetary performance in the health services sector. Based on a sample of 170 managers, the results indicate that highly committed managers react very differently to reliance on financial measures for performance evaluation and budgetary participation from lowly committed managers. Differences were also found between managers from the privately funded service organisations and those from the publicly funded service organisations.
Kai-Lit Phua and Simon Barraclough
Privatization as a general policy was introduced into Malaysia in the 1980s. Subsequently, selected elements of the public health-care system were privatized. This chapter…
Abstract
Privatization as a general policy was introduced into Malaysia in the 1980s. Subsequently, selected elements of the public health-care system were privatized. This chapter analyzes the effects of privatization on the health-care system in terms of both intended and unintended consequences. The outflow of experienced specialist doctors from the public sector to the private sector and the emergence of a two-class system of health care in Malaysia have been major unintended consequences of privatization.
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Anne Mills and Jonathan Broomberg
This chapter draws on a study conducted in the mid 1990s to compare management differences between three different groups of South African hospitals, in order to understand how…
Abstract
This chapter draws on a study conducted in the mid 1990s to compare management differences between three different groups of South African hospitals, in order to understand how these differences might have affected hospital functioning. The groups were public hospitals; contractor hospitals publicly funded but privately managed; and private hospitals owned and run by private companies. Public sector structures made effective management difficult and were highly centralized, with hospital managers enjoying little autonomy. In contrast, contractor and private groups emphasised efficient management and cost containment. These differences appeared to be reflected in cost and quality differences between the groups. The findings suggest that in the context of a country such as South Africa, with a relatively well-developed private sector, there is potential for the government to profit from the management expertise in the private sector by identifying lessons for its own management structures, and by contracting-out service management.
Arshad Ali JAVED, Patrick T.I. Lam and Albert P.C. Chan
Social infrastructure projects such as hospitals are increasingly being procured through public private partnerships (PPP). Due to their complex nature and very high operational…
Abstract
Purpose
Social infrastructure projects such as hospitals are increasingly being procured through public private partnerships (PPP). Due to their complex nature and very high operational requirements, these healthcare projects need special attention in developing robust output specifications at the early procurement stage. The purpose of this paper is to present a model framework of output specifications for adoption by public sector clients in jurisdictions planning to develop hospital PPP/PFI (Private Finance Initiative) projects.
Design/methodology/approach
The research is based on an in-depth analysis of best practices from standard and sample project output specification documents used in Australia and the UK for completed hospital projects, reinforced by interviews with key stakeholders in the two countries.
Findings
Drafting output specifications for hospital PPP projects is perceived to be a difficult and challenging task due to the complexity and changing needs brought about by evolving health policy, technology and medical advancement. The overarching target of preparing good output specification is to achieve value for money, innovation, risk transfer (including catering for changes), whole life asset performance and establishing performance criteria to link up with the payment mechanism.
Practical/implications
The proposed framework is built up from public sector requirements on the physical asset, operational services provided by the private sector, with links to payment mechanism and performance evaluation. It also addresses change mechanism as well as conditions upon hand-over back to the public sector.
Originality/value
Unlike traditional projects which are procured using prescriptive specifications, PPP/PFI projects are procured using performance based output specifications. This paper provides the foundation and a model framework for preparing comprehensive output specifications based on best practices in Australia and the UK, using hospital as the contextual background.
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Julie E.M. Scott, Jill L. McKinnon and Graeme L. Harrison
This study traces the development of financial reporting in two publicly funded hospitals in New South Wales over the period 1857 to post‐1975, with particular focus on the use of…
Abstract
This study traces the development of financial reporting in two publicly funded hospitals in New South Wales over the period 1857 to post‐1975, with particular focus on the use of cash and accrual accounting. The historical analysis draws on process and contextual change and stakeholder theory, and uses both primary and secondary data, to describe patterns of change (and non‐change) in the hospitals’ financial reporting and to identify the social and political influences associated with such reporting. The study provides historical context for recent developments in public sector reporting and accountability in Australia, particularly the (re)introduction of accrual accounting, and provides insights into the nature of accounting change both in public sector organizations and generally.
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Muhammad Naeem and Wilson Ozuem
Competitive pressure and social influence for technology adoption have increased among developed, developing and emerging countries. The influence of social structure…
Abstract
Purpose
Competitive pressure and social influence for technology adoption have increased among developed, developing and emerging countries. The influence of social structure, organizational forces and political forces varies between public sector hospitals in countries where there are more social media restrictions. This study aims to explore how the use of social media can influence employee engagement and productivity in the workplaces of public sector hospitals.
Design/methodology/approach
The study follows a social constructivist approach to understand employee attitudes, motivation culture, political forces and the local context. Data were collected from health professionals of five public sector hospitals using a non-directive and semi-structured interview method.
Findings
The results show that the use of social media sites has increased collaboration, coordination and cooperation among health professionals, especially in critical situations. They are more socialized, connected and engaged, thus helping them to exchange useful knowledge using instant messaging apps. Conversely, there are no organizational polices and specific laws and too little support from management and senior doctors to drive the use of social networking sites in public hospitals. The use of social media has enhanced health professionals' engagement and productivity as they are able to share their expertise, knowledge and information with their colleagues and subordinates.
Research limitations/implications
The results can guide policy-makers, researchers, hospitals, doctors and the Ministry of Health about the positive use of social networking sites in the workplace. The positive use of social networking sites in the workplace can enhance information, knowledge and coordination which may help to enhance employee engagement and productivity.
Originality/value
The present study has provided a social media health organization workplace (SMHOW) model which explains how individual and organizational contexts can influence the actual use of social media in healthcare organizations.
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Saad Ahmed Javed and Fatima Ilyas
The purpose of this paper is to assess the influence of patients’ expectations from healthcare service quality on their satisfaction with nursing in public and private hospitals…
Abstract
Purpose
The purpose of this paper is to assess the influence of patients’ expectations from healthcare service quality on their satisfaction with nursing in public and private hospitals of Pakistan.
Design/methodology/approach
Data (n=456) were collected from three public sector hospitals and three private sector hospitals of Lahore, the capital of Pakistan’s most populous province. Male and female patients who have experience of both sectors were surveyed using a self-administered questionnaire developed using the original SERVQUAL approach. Data were analyzed using the statistical techniques and the Laplace criterion.
Findings
This paper attempts to explain degree of influences of five service quality constructs (empathy, responsiveness, tangibility, reliability and assurance) on Pakistani patients’ expectations from the private and public sector hospitals and thus patient satisfaction. Further, this work can offer several intuitions into the effect of five constructs of service quality on patients’ expectations of healthcare service quality and patient satisfaction with the service providers/nursing. The results reveal that the patient satisfaction is most strongly related to empathy in public sector and to responsiveness in private sector.
Research limitations/implications
In light of the previous studies and the current research findings, the study anticipates no apparently significant improvement in healthcare sector of Pakistan in near future considering various factors discussed in the study. The study will also help the service providers and the policy makers in understanding the deteriorating situation of the Pakistani healthcare sector and will guide them in identifying the areas by improving which not only the healthcare service quality in the country can be improved but also the image of healthcare sector among the masses and competitiveness of the healthcare sector can be enhanced.
Originality/value
The value of the study rests in its critical analysis of the current status of the healthcare sector of Pakistan with a view to suggest the areas that need to be worked on by the service providers and policy makers. Also, the study tries to settle a controversy within Pakistani healthcare literature concerning the question that who is producing more satisfied patients: private hospitals or their public counterparts?
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