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Article
Publication date: 1 October 2005

Vasco Eiriz and José António Figueiredo

To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key…

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Abstract

Purpose

To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically.

Design/methodology/approach

Systematic review of the literature.

Findings

Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non‐technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence).

Originality/value

This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing‐oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 April 2007

Jenny Robb and Peter Gilbert

Integration is a watchword in Government policy, designed to give more seamless, and therefore more effective, services to people in need. One concern, though, is that…

134

Abstract

Integration is a watchword in Government policy, designed to give more seamless, and therefore more effective, services to people in need. One concern, though, is that this is merely a ‘structural’ approach that just rearranges the deckchairs. This paper gives a practical example of a positive, local leadership approach to integration within a national context.

Details

International Journal of Leadership in Public Services, vol. 3 no. 1
Type: Research Article
ISSN: 1747-9886

Keywords

Open Access
Article
Publication date: 29 July 2022

Ntibaneng Hunadi Maleka and Walter Matli

The purpose of this study is to provide current state of knowledge on how the COVID-19 emergency situation necessitated the behaviour influencing use and acceptance of…

Abstract

Purpose

The purpose of this study is to provide current state of knowledge on how the COVID-19 emergency situation necessitated the behaviour influencing use and acceptance of telehealth. This study interlinks the health belief model (HBM) and the unified theory of acceptance and use of technology (UTAUT) to highlight the challenges and opportunities as a result of the COVID-19 pandemic in the public health sector.

Design/methodology/approach

This study used three online databases (Emerald publishing, Science Direct and Taylor and Francis) that enabled the authors to access electronic journal articles. Search strategy was used to extract articles based on the relevance of this study.

Findings

The key findings from this study suggested that the COVID-19 emergency forced health-care workers and their patients to rapidly use and rely on telehealth to reduce the rate of COVID-19 transmissions. The key benefits of telehealth use highlighted an expansive cost effective and convenient access to health-care services irrespective of geographical local and levels of physical impairment. Moreover, telehealth inhibited in person human interaction, which was perceived as impersonal and not ideal for new patient consultations. The barriers outweighed the benefits; as a result, it is unlikely that there will be a wide use of telehealth beyond the COVID-19 emergency situation.

Practical implications

The research findings are limited to discussions drawn from available secondary data. The criteria within telehealth for policymakers to note the technology acceptance and use for both health-care and outpatient stakeholders and their health seeking behaviour. Health-care sectors (private and public) and government need to understand enablers of effective telehealth in policymaking to ease the barriers during an emergency situation like a pandemic.

Originality/value

This study contributes to the emerging literature on how COVID-19 pandemic has disrupted and accelerated telehealth by extending both the UTAUT and HBM theories. This study is expected to contribute and expand literature on telehealth during emergency situations, given the novice nature of COVID-19 and limited literature surrounding it.

Details

Journal of Science and Technology Policy Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2053-4620

Keywords

Article
Publication date: 1 December 2006

Helen Tucker

There is a strong tradition of integration in rural community hospitals which has been largely unrecognised in the past. The national strategy for health in England now…

Abstract

There is a strong tradition of integration in rural community hospitals which has been largely unrecognised in the past. The national strategy for health in England now gives community hospitals a central role in providing integrated health and social care, in a policy referred to as ‘care closer to home’. The evidence emerging from international and national studies is demonstrating the benefit of the community hospital model of care. Public support for community hospitals over their 100‐year history has been strong, with value being placed on accessibility, quality and continuity. There is, however, a tension between the national policy and the current financial pressures to close or reduce services in one in three community hospitals in England. Innovative ways of owning and managing these services are being put forward by communities who are actively seeking to maintain and develop their local hospitals. The challenge is to demonstrate that community hospital services are valued models of person‐centred integrated care, and to demonstrate their contribution to the health and well‐being of their communities.

Details

Journal of Integrated Care, vol. 14 no. 6
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 24 May 2022

Jacob Mickelsson, Ulla Särkikangas, Tore Strandvik and Kristina Heinonen

People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need…

Abstract

Purpose

People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need. Complex health conditions frequently transcend the scope of typical health-care service systems. The purpose of this paper is to explore and characterize such unique assemblages of actors and services as “user-defined ecosystems”.

Design/methodology/approach

Building on literature on customer ecosystems, this paper introduces the concept of the user-defined ecosystem (UDE). Using an abductive approach, the authors apply the concept in an interpretive, qualitative study of ten families with special needs children.

Findings

This study uncovers complex UDEs, where families actively combine a broad range of services. These ecosystems are unique for each family and extend beyond the scope of designed service ecosystems. Thus, the families are forced to assume an active, coordinating role.

Research limitations/implications

This paper shows how to identify ecosystems from the user’s point of view, based on the selected user unit (such as a family) and the focal value-creating function of the ecosystem for the user.

Social implications

This paper highlights how service providers can support and adapt to UDEs and, thus, contribute to user value and well-being. This can be used to understand users’ perspectives on service and systems in health and social care.

Originality/value

This study develops the concept of the UDE, which represents a customer-focused perspective on actor ecosystems and contrasts it with a provider-focused and a distributed perspective on ecosystems. This study demonstrates the practical usefulness of the conceptualization and provides a foundation for further research on the user’s perspective on ecosystems.

Details

Journal of Services Marketing, vol. 36 no. 9
Type: Research Article
ISSN: 0887-6045

Keywords

Book part
Publication date: 21 October 2008

Ethel G. Nicdao, Seunghye Hong and David T. Takeuchi

Objective: Our study examines the association between social support and use of mental health services in Asian American men and women. Specifically, we report on the…

Abstract

Objective: Our study examines the association between social support and use of mental health services in Asian American men and women. Specifically, we report on the association between types of social support and types of health services used (general medical care and specialty mental health care).

Method: We use data from the National Latino and Asian American Study, a nationally representative survey of the US household population of Latino and Asian Americans. Our present study is based on data from the sample of Asian Americans (N = 2,095).

Results: Overall, our findings suggest that Asian Americans use general medical care services more than specialty mental health care. Our findings also showed variations in levels of social support, and the use of health services among different Asian subgroups (Vietnamese, Filipino, Chinese, and Other Asian) and nativity status (US-born versus foreign-born Asians). Specific types of social support influenced the use of specialty mental health care services, while other types of social support inhibited use of specialist services.

Conclusion: Compared to using generalist services, Asian Americans demonstrated lower rates of using specialist services. Our results emphasize the importance of considering other social factors to explain between group differences as well as factors contributing to the underutilization of specialty mental health services by Asian Americans.

Details

Care for Major Health Problems and Population Health Concerns: Impacts on Patients, Providers and Policy
Type: Book
ISBN: 978-1-84855-160-2

Book part
Publication date: 1 January 2006

Vicky M. MacLean, Patricia Parker and Melissa Sandefur

The study assesses public health programs to shed light on the experiences of low-income and minority women with children seeking health services. Thirteen focus groups…

Abstract

The study assesses public health programs to shed light on the experiences of low-income and minority women with children seeking health services. Thirteen focus groups were conducted with 111 pregnant women or women with children. Women consumers of public health services experience difficulties accessing health services due to a lack of insurance, information and language barriers about programs and eligibility, a shortage of Medicaid providers and specialist services, long waits, bureaucratic barriers, and dismissive treatment. Accessibility and information barriers were more prominent in rural regions whereas bureaucratic barriers were more pronounced in urban areas. Lower satisfaction with services was reported among ethnic minority women compared to whites.

Details

Access, Quality and Satisfaction with Care
Type: Book
ISBN: 978-1-84950-420-1

Book part
Publication date: 13 October 2014

Jennifer S. Reinke and Catherine A. Solheim

Using Andersen’s (1968) behavioral model of health services use as a guiding conceptual framework, this study examined how receipt of family-centered care relates to the…

Abstract

Purpose

Using Andersen’s (1968) behavioral model of health services use as a guiding conceptual framework, this study examined how receipt of family-centered care relates to the perceived family challenges for families of children with autism spectrum disorder (ASD).

Design

Data from the 2009–2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were analyzed for 812 parents of children with ASD.

Findings

Multiple regression analyses provided substantive statistical evidence that a child’s race, the adequacy of a family’s insurance, and the stability of child’s health care needs significantly contributed to predicting his or her receipt of family-centered care. Further results suggested a relationship between receipt of family-centered care and the perception of challenge for these families; families receiving family-centered care perceive fewer challenges and feel less unmet need for child health services.

Value

Family-centered professionals provide critical voices in the development of policies and programs geared toward improving the health outcomes of children with ASD and their families.

Details

Family Relationships and Familial Responses to Health Issues
Type: Book
ISBN: 978-1-78441-015-5

Keywords

Book part
Publication date: 8 August 2016

Luma AlMasarweh and Carol Ward

This study aims to provide a better understanding of Native American women veterans’ experiences with Veteran Administration and Indian Health Services. Eighteen…

Abstract

Purpose

This study aims to provide a better understanding of Native American women veterans’ experiences with Veteran Administration and Indian Health Services. Eighteen interviews were conducted with special attention to the quality and quantity of health and mental health care services veterans accessed, the barriers and local contextual factors in accessing and utilizing services, and potential solutions to service gaps for women veterans from two Montana reservations, the Northern Cheyenne Reservation and the Confederated Salish and Kootenai Tribes of the Flathead Reservation.

Methodology/approach

We examine the barriers and needs of Native American veterans in both reservations using qualitative methods. The research analyzed 18 interviews with women veterans from the Northern Cheyenne and Flathead reservations.

Findings

Native American women veterans identified a number of barriers to accessing care, some of which include lack of information regarding eligibility and the types of services available. Women often found the application process to be confusing and difficult. Other barriers included distance, cost of travel, and conflicts with their work schedule.

Research limitations/implications

This exploratory case study served to clarify the challenges and obstacles Native American women veterans experience with accessing health and mental health services. This research revealed several patterns and themes in the experience of Native American women veterans in both reservation communities when attempting to access and seek care at Veterans Administration (VA) facilities and Indian Health Services (IHS). This research calls for policy changes and research to clarify how resources can be more efficiently and effectively distributed to rural veterans.

Originality/value

Little research has addressed the needs of Native American veterans. American Indians and Alaska Natives serve at a higher rate in the U.S. military than any other population. This research provides important information about Native American veterans who are often underrepresented in survey research, yet a rapidly growing segment of the United States military and veteran population.

Details

Special Social Groups, Social Factors and Disparities in Health and Health Care
Type: Book
ISBN: 978-1-78635-467-9

Keywords

Open Access
Book part
Publication date: 6 May 2019

Denise Alexander, Uttara Kurup, Arjun Menon, Michael Mahgerefteh, Austin Warters, Michael Rigby and Mitch Blair

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental…

Abstract

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

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