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1 – 10 of 942This paper aims to examine the factors that affect the quality of healthcare services in the implementation of the National Health Insurance Scheme (NHIS) at the local level in…
Abstract
Purpose
This paper aims to examine the factors that affect the quality of healthcare services in the implementation of the National Health Insurance Scheme (NHIS) at the local level in Ghana from the perspectives of health policy implementers and beneficiaries in public-private organisations.
Design/methodology/approach
This paper has adopted a mixed research method with both qualitative and quantitative data, with in-depth interviews, document analysis and focus groups discussions. A total of 107 participants took part in the interviews and the questionnaire survey.
Findings
The study found that these factors greatly affect the quality of healthcare services from the implementers’ perspectives — referrals, effectiveness in monitoring, timeliness, efficiency, reimbursement, compliance with standard guidelines of Ghana Health Service (GHS) and accreditation process. For the beneficiaries, three healthcare services factors are important, including medical consultations, diagnostic services and the supply of drugs and medicines. Some other factors are found to be the least prioritized healthcare services, namely the issuance of prescription forms, verification of identification (ID) cards and staff attitude. However, the study found that implementers and beneficiaries exhibited a mixed reaction (perspectives) on accessing some healthcare services. In some healthcare services where the implementers perceived that beneficiaries have more access to such services, the beneficiaries think otherwise, an irony in the perspectives of the two actors.
Originality/value
This paper adds to the extant literature on the perspectives of policy implementers and beneficiaries on factors that affect the quality of healthcare services in general and specifically on the implementation of NHIS in Ghana with the public-private dimension.
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Mohamed Nisfar Changaranchola and Rabinarayan Samantara
The present research paper aims to examine the inter-relationship between organizational justice (Henceforth termed as OJ), psychological well-being at work (henceforth termed as…
Abstract
Purpose
The present research paper aims to examine the inter-relationship between organizational justice (Henceforth termed as OJ), psychological well-being at work (henceforth termed as PWBW) and organizational citizenship behavior (henceforth termed as OCB). More specifically, this paper attempts to critically analyze the mediating role of PWBW in the relationship between OJ and OCB. The study solely focuses on nurses working at private hospitals in Kerala, who are the largest group of healthcare personnel.
Design/methodology/approach
Data collected from 308 nursing employees were analyzed by using statistical package for the social sciences (SPSS) software.
Findings
The outcomes of the analysis demonstrate that significant correlations exist between all the three key variables and their dimensions. Moreover, it has been found that the relationship between OJ and OCB is partially mediated by PWBW.
Research limitations/implications
In the present healthcare scenario, just after the Covid-19 pandemic, there is a paramount need for the well-being of healthcare staff in order to improve the functioning of the healthcare system.
Originality/value
The study enabled us to develop and provide an explanation as to how social exchange relationship works between OJ and OCB.
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This study aims to document students’ supply chain solutions developed through the internship hackathon program. The study profiled innovative solutions developed by university…
Abstract
Purpose
This study aims to document students’ supply chain solutions developed through the internship hackathon program. The study profiled innovative solutions developed by university students in Kenya to solve health supply chain logistics challenges during and beyond COVID-19. This is done by exploring students’ experience in developing sustainable logistics and supply chain management capacity-building programs in a low-middle-income country (LMIC).
Design/methodology/approach
This study used a qualitative approach to explore the experiences and perceptions of students and mentors who participated in a hackathon program. The study followed a cross-sectional descriptive survey design, collecting data from the participants through online questionnaires. The data were analyzed and presented using thematic analysis and narrative techniques.
Findings
Findings provide preliminary evidence for narrowing the gap between theory and practice through a hackathon internship blended with a mentorship program. Assessment of this program provides evidence for developing solutions toward ensuring the availability of essential medicine in LMICs during a pandemic such as COVID-19 by students. The profiled solutions demonstrate a broader perspective of innovative solutions of university students, mentors and potential opportunities for a triple helix approach to innovation for health supply chain system strengthening.
Research limitations/implications
This original study provides evidence for advancing contribution to developing innovative solutions through partnerships between investors, universities and industry practitioners interested in mentoring students in the health-care supply chain during COVID-19 in LMICs. Specifically, contingency factors that affect the implementation of innovative programs during and beyond global pandemics such as COVID-19 by students’ innovators are identified, and implications for policy action are discussed based on the praxis of sensemaking.
Practical implications
This study examines a novel approach that combines internship, mentorship and hackathon projects for logistics and supply chain students in LMICs. The approach aims to bridge the gap between theory and practice and to create innovative solutions for essential medicines during and after COVID-19. The study urges more resources for supporting such programs, as they benefit both academia and industry. The study also argues that hackathon internship programs can help the logistics and supply chain industry adapt to the post-pandemic era. The study offers insights for investors, universities and practitioners in the health-care industry.
Originality/value
This study shows how to develop innovative solutions for the health-care supply chain during COVID-19 in an LMIC through partnerships between investors, universities and industry practitioners who mentor students. The study identifies the contingency factors that influence the success of such programs during and beyond global pandemics such as COVID-19 and discusses the policy implications based on the sensemaking praxis of the student innovators.
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Sabina De Rosis, Chiara Barchielli, Milena Vainieri and Nicola Bellé
User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on…
Abstract
Purpose
User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.
Design/methodology/approach
65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.
Findings
Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.
Research limitations/implications
Different features referring to different nursing models make the difference in producing an excellent user experience with the service.
Practical implications
These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.
Originality/value
This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.
Highlights
This is one of the first studies on the relationship between provision models of nursing care and patient experience.
Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.
Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.
Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.
This is one of the first studies on the relationship between provision models of nursing care and patient experience.
Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.
Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.
Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.
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Veronica Ungaro, Laura Di Pietro, Roberta Guglielmetti Mugion and Maria Francesca Renzi
The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting…
Abstract
Purpose
The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.
Design/methodology/approach
Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.
Findings
The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.
Originality/value
This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.
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Sabina De Rosis, Kendall Jamieson Gilmore and Sabina Nuti
Using data from a continuous and ongoing cross-sectional web survey on hospitalisation service experiences in two Italian regions, the authors used multilevel and multivariate…
Abstract
Purpose
Using data from a continuous and ongoing cross-sectional web survey on hospitalisation service experiences in two Italian regions, the authors used multilevel and multivariate logistic regression models to identify factors related to users' demographics, emotional and informative support, technical and physical aspects of the provision, influencing satisfaction and willingness-to-recommend, before and during a crisis.
Design/methodology/approach
The value-in-use, defined in terms of a positive or negative value given by the experience with services, can be evaluated by users and influenced by the context of provision. The authors tested whether and how the value-in-use of services changed in a context of crisis. This study is applied to the healthcare sector during the coronavirus disease 2019 (COVID-19) epidemic, by evaluating the impact of the pandemic on hospitalisation experience.
Findings
Overall, analyses of 8,712 questionnaires found a greater value after the pandemic spread. In a time of crisis, technical and informative aspects of care were found to be most valued by patients that may recognise the extraordinary professionalism of workers during the crisis.
Research limitations/implications
This study empirically suggests that context can affect the evaluation of value-in-use by patients during unprecedented circumstances, producing additional value-in-context.
Practical implications
These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.
Social implications
The level of healthcare system distress, due to the COVID-19 epidemic, positively affects patients' propensity to recommend, which the authors suggest is driven by healthcare services' feelings of reverse compassion. These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience, which can have positive social implications. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.
Originality/value
Research based on the intersection of theoretical and empirical research regarding value-in-use, value-in-context and service quality measured through user experience is scarce, in particular in the healthcare sector. The authors' findings set the direction for future research on the influence of context on value creation and value creation's perception by users, on the concept of reverse compassion and on reverse compassion's impact on organisational well-being, particularly in times of crisis.
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Karin Nilsson, Bodil J. Landstad, Kerstin Ekberg, Anna Nyberg, Malin Sjöström and Emma Hagqvist
This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial…
Abstract
Purpose
This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care.
Design/methodology/approach
The study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material.
Findings
The analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients.
Practical implications
The study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services.
Originality/value
This paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis.
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Noah Olasehinde, Uche Abamba Osakede and Abdulfatai Adekunle Adedeji
This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of…
Abstract
Purpose
This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of user fees on waiting time at public healthcare facilities were examined. User fees are vital for the fiscal sustainability of healthcare provision for most African economies. Its imposition could debar healthcare access by the poor while its removal can reduce quality of care and induce longer waiting time.
Design/methodology/approach
The wave 3 of the Nigerian General Household Survey (2015/16) data was used for users of public health facilities. Access to healthcare was modelled using utilization data in a logistic regression model while waiting time was through the Negative Binomial Regression Model (NBRM).
Findings
The analyses showed significant effects of user fees on access to both preventive and curative care and on time spent waiting to make use of healthcare services. Individuals were able to access healthcare services regardless of amounts paid. Also, there was a non-negative effect of user fee imposition on waiting time.
Practical implications
Nigeria should improve healthcare facilities to address the enormous demand for healthcare services when designing policy for health sector.
Originality/value
This paper shows that even with the imposition of user fees, healthcare facilities could still not cater for the rising healthcare needs of the populace but cautioned that its abolition may not be a preferred option.
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Siphiwe Themba Madlala, Maureen Nokuthula Sibiya and Thembelihle Sylvia Patience Ngxongo
The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student…
Abstract
Purpose
The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student accoucheurs studying at the Free State School of Nursing are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal healthcare institutions. This results in poor quality of training of student accoucheurs in maternal healthcare. Considerable studies have been conducted on males in midwifery nursing, but no guidelines have been developed to facilitate student accoucheurs' acceptance and improvement of the quality of training in maternal healthcare, hence the purpose of this study.
Design/methodology/approach
A descriptive, explorative qualitative design was used in this study. Qualitative focused group discussions (n = 32) were conducted through purposeful sampling method. Data was analysed thematically.
Findings
Three main categories emerged: student accoucheurs' related factors with social interactions and relations as a theme; maternal healthcare users’ related factors with transcultural diversity and socio-economic status as themes; nurse training institutions and maternal healthcare institutions service providers-related factors with gender inequality in the work place as a theme. Ultimately, the guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in maternal healthcare institutions were developed and recommended for implementation.
Originality/value
The paper developed guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in Free State maternal healthcare institutions.
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Olusegun Emmanuel Akinwale and Olusoji James George
The mass exodus of the professional healthcare workforce has become a cankerworm for a developing nation like Nigeria, and this worsens the already depleted healthcare systems in…
Abstract
Purpose
The mass exodus of the professional healthcare workforce has become a cankerworm for a developing nation like Nigeria, and this worsens the already depleted healthcare systems in underdeveloped nation. This study investigated the rationale behind medical workers' brain-drain syndrome and the quality healthcare delivery in the Nigerian public healthcare sector.
Design/methodology/approach
To stimulate an understanding of the effect of the phenomenon called brain drain, the study adopted a diagnostic research design to survey the public healthcare personnel in government hospitals. The study administered a battery of adapted research scales of different measures to confirm the variables of interest of this study on a probability sampling strategy. The study surveyed 450 public healthcare sector employees from four government hospitals to gather pertinent data. The study used a structural equation model (SEM) and artificial neural networks (ANNs) to analyse the collected data from the medical personnel of government hospitals.
Findings
The findings of this study are significant as postulated. The study discovered that poor quality worklife experienced by Nigerian medical personnel was attributed to the brain-drain effect and poor healthcare delivery. The study further demonstrated that job dissatisfaction suffered among the public healthcare workforce forced the workforce to migrate to the international labour market, and this same factor is a reason for poor healthcare delivery. Lastly, the study discovered that inadequate remuneration and pay discouraged Nigerian professionals and allied healthcare workers from being productive and ultimately pushed them to the global market.
Originality/value
Practically, this study has shown three major elements that caused the mass movement of Nigerian healthcare personnel to other countries of the world and that seems novel given the peculiarity of the Nigerian labour market. The study is original and novel as much study has not been put forward in the public healthcare sector in Nigeria concerning this phenomenon.
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