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The aim of this chapter is to understand the nature of business collaboration between healthcare service providers and tourism agencies in Malaysia. Interviews with 17 healthcare service providers in Malaysia reveal that most of the collaboration between healthcare service providers and tourism agencies in Malaysia is informal or loose, despite their intention to leverage on medical tourism for business expansion. Close and tight collaborations are rare. The findings point towards the main reasons behind the rare collaboration which are the high customer orientation of healthcare service providers, the strategic move of business and support for government agenda.

The Persons with Disabilities (PWDs) Act, 2006 (Act 715) was passed in Ghana to grant several rights to PWDs, including access to public services such as healthcare. This paper investigates the inequality in resources and then later assesses the effect of disability on healthcare utilization if all resources are distributed equally between disabled and not disabled persons.

The study uses data from the seventh round of the Ghana Living Standards Survey (GLSS 7), which was conducted in 2016/2017, and employs the estimation method of propensity score matching (PSM), within the framework of the capability approach (CA).

The findings are that there is a disparity in the resources and conversion factors needed to utilize healthcare. Compared to not disabled persons, persons living with disability are more likely to be poorer but pay more out of pocket because they are more likely to be uninsured. They are also older, male, uneducated and live in rural areas. They are also likely to spend more money but less time to travel to the health facility, and they wait longer to receive treatment. After matching these background characteristics, disability reduces healthcare utilization by 12.4%.

The research is limited by the lack of information about the reasons for seeking healthcare by the persons living with disability, whether it is for general treatment as any other person or for treating the disability.

Persons with disability are less endowed. However, even if they have the same resources as their abled counterparts, disability will still reduce healthcare utilization.

This paper identifies and addresses all forms of inequality with respect to healthcare utilization, within Amartya Sen’s Capability Approach.

Persons living with disability are less likely to seek treatment when ill. This is understandable since there is a disparity in the resources and conversion factors needed to utilize healthcare. However, after matching these background characteristics, just being disabled still reduces healthcare utilization. The paper uses Sen’s CA framework.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-02-2022-0084

The present study aims to explore the barriers to Lean Six Sigma (LSS) implementation in the healthcare sector and develop the ranking of finalized barriers using the Decision-Making Trial and Evaluation Laboratory (DEMATEL) approach under a fuzzy environment.

The LSS barriers are identified through the literature review and validated by the expert's opinion and statistical analysis. A total of 124 experts were identified through the purposive sampling method for conducting this study. A questionnaire survey method is used to collect the data related to identified LSS barriers in the healthcare sector. The screened barriers are ranked through the Fuzzy DEMATEL approach.

In this study, a total of 21 barriers were identified with the help of a systematic literature review and screened 13 significant barriers by the expert opinions of healthcare personnel. The result reveals that “Lack of top management commitment and support, lack of awareness about LSS”, “resistance to culture change and inadequate resources emerges as the most critical barriers”. The prioritization of barriers facilitates the managers to make effective policies and guidelines for LSS implementation in healthcare organizations.

To avoid LSS implementation failure, the practitioners and researchers need to focus on LSS barriers as per suggested ranking more conventionally and make plans and adoption policies accordingly.

This study is unique in terms of investigation and empirical analysis of LSS implementation barriers in the healthcare sector in the Indian context. The outcomes of the present study will help the managers of healthcare organizations to make the strategies and policies for LSS implementation as per the recommended LSS barriers.

This study aims to investigate the consequence of the quality of governance (QoG) in moderating the effect of healthcare spending on human development.

The authors employ a two-step Windmeijer finite sample-corrected system-generalized method of moments (sys-GMM) estimation technique on a panel dataset of 161 countries from 2005 to 2019. The authors use healthcare expenditure as the main explanatory variable and the Human Development Index (HDI) as the dependent variable and also consider voice and accountability (VnA), political stability and absence of terrorism (PSnAT), governance effectiveness (GoE), regulatory quality (ReQ), rules of law (RLaw) and control of corruption (CoC) dimensions of governance indicators as proxies of good governance. The authors develop a new measure of good governance from these six dimensions of governance using principal component analysis (PCA).

The authors empirically revealed that allocating more healthcare support alone is insufficient to improve human development. Individually, PSnAT has the highest net positive effect on health expenditure that helps to increase human welfare. Further, the corresponding interaction effect between expenditure and the Good Governance Index (GGI) is negative but insignificant for low-income countries (LICs); negative and statistically significant for sub-Saharan African (SSA) economies and positive but insignificant for South Asian nations.

This study is an in-depth analysis of how governance impacts the effectiveness of healthcare expenditure to ensure higher human development, particularly in a large panel of 161 countries. The authors have developed a new index of good governance and later extended the analysis by separating countries based on the income level and geographical location, which are utterly absent in existing literature.

Purpose – This paper seeks to look at healthcare service quality from the viewpoint of its negative impact on the industry when there is a deficiency in the delivery of service quality. To measure this impact, the potential loss of customers due to poor quality service is measured. A potential customer loss model is proposed. To address the competitive and financially driven healthcare delivery business, a three‐pillar approach, termed the Excellent Healthcare Service Model (EHSM), is introduced. This approach advocates that the healthcare industry should use a system view to deliver quality healthcare by taking into account quality, cost, and efficiency factors in a holistic manner. Design/methodology/approach – In this paper a survey questionnaire was used to gather data necessary to compute impact of deficient healthcare service. The questionnaire was administered to a sample of 400 people and the survey method used was intercept interview. Customer loss and potential customer loss due to deficient service were computed. Findings – In this paper, findings from the research indicated that, in the healthcare industry, for every 100 customers that experienced deficient service, about 70 customers would be unlikely to patronize the same organization again. In addition, for the same 100 customers who have experienced deficient service, about 75 of them will go on to tell on average nine family members and friends about their experiences. Through word of mouth from these 75 dissatisfied customers, there will eventually be about 465 persons who might have been potential customers but will probably not patronize the organization at all based on what the dissatisfied customers have told them. Practical implications – The ideas presented in this paper provide a new way of looking at service quality performance, through the impact of deficient service. With this knowledge, economic impacts of poor service quality could easily be quantified, and such economic‐based results are usually a better motivator for managers and workers to deploy quality improvement initiatives. Originality/value – The results and ideas presented in this paper are valuable for the healthcare industry. It provides an alternative approach to quantify service quality performance. The paper also proposes a system‐based approach to enhance service process performance.

The purpose of this paper is to develop a framework for the improvement of healthcare services through an effective human resource management system. The case study highlights a need to analyze human resource management processes that exist in healthcare sector and suggests better ways to achieve higher levels of patient satisfaction.

The methodology consists of first developing a conceptual framework for human resource management in healthcare industry. The proposed framework comprises of three parts: inputs which include determining employee competencies, HR planning, job analysis, recruitment, selection, compensation benefits, pay/rewards, labor and employee relations; processes (training and development) focus on healthcare systems; and outputs which include quality, cost, technology, and responsiveness leading to patient satisfaction. Then, the framework has been studied with help of a case study conducted in a hospital in India.

The most important skill required for healthcare workforce to deliver high-quality care to patients is the human resource development. By appropriate workforce development, healthcare organizations can provide high-quality services to patients. Finally, it derives a set of conclusions from the case study research. Further research would be needed to validate the framework through empirical data.

This research is a new attempt as there is a limited research done earlier on the framework of human resource management in healthcare system and services. It is designed to facilitate training and development at both the individual and at organizational levels, advocating a balance between “healthcare employee” and “healthcare system.”

The purpose of this research study was to obtain healthcare executives’ perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color.

A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified.

The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles.

This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics.

The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of color in leadership roles that guide healthcare policy and access. This study connects contemporary literature to perspectives of executives in the field and offers practical solutions to improving the representation of people of color in executive healthcare leadership roles.

The recommendations offered as a result of this research effort serve to create awareness of the challenges that people of color face in career attainment. Although the process of increasing the representation of people of color in executive healthcare leadership will be a complex task that will involve a number of players over the course of several years, this study serves to provide a practical roadmap with actionable tactics that can be deployed.

This paper is an extension of the work that was done by the author during the course of completing the program requirements for the author’s doctoral program. The findings were previously discussed in the author’s dissertation. The value of these findings is significant because they validate some of the topics in contemporary literature with the perspectives of practicing healthcare executives. This study is also unique from other studies in that it offers a long-term plan to increase the representation of people of color in executive roles by creating an early disposition toward executive level roles and identifies a number of practical steps toward that end.

Competition rules maximise consumer welfare by promoting efficient use of scarce resource and thus high output, low prices, high quality, varied services, innovation, production and distribution. European courts consider doctors and hospital staff as undertakings (any entity that performs economic activities), so that if they enter into agreements then they have to comply with competition rules. This paper's objective is to determine whether competition law, which applies to undertakings, can in fact be applied to different healthcare‐sector players and whether specific rules are needed regarding competition between healthcare undertakings.

Data were selected from relevant European and national case law, European institution legal documents (such as regulations, guidelines and communications) and healthcare competition law literature, and then examined.

The paper finds that competition rules are applicable to healthcare players considering the consequences if competition rules are applied to the healthcare market. For market processes to result in the appropriate cost, quality and output, competition law must be proactive. In other words, quality must be fully factored into the competitive mix, allowing consumers to weigh healthcare price and non‐price characteristics.

Countries have different healthcare system and competition rules (although similar), competition rule impact is different for each country. Some healthcare systems are more regulated and there will be less opportunity for healthcare players to compete.

Efficiently applying competition law to healthcare players means that several challenges need facing, such as healthcare quality complexity and court scepticism.

This article points out the challenges when competition law is applied to the healthcare sector and how these challenges are faced in certain countries such as The Netherlands.

Currently the healthcare industry in the US is not only contending with relentless pressures to lower costs while maintaining and increasing the quality of service but is also under a stringent timeline to become compliant with the health insurance, portability and accountability act (HIPAA) regulatory requirements. Robust healthcare information systems (HCIS) become critical to enabling healthcare organizations address these challenges. Hence, it becomes an imperative need that the information that is captured, generated and disseminated by these HCIS be of the highest possible integrity and quality as well as compliant with regulatory requirements. This paper addresses this need by proposing an integrative framework for HIPAA compliant, I*IQ HCIS. It bases this framework on an integration of the requirements for HIPAA compliance, the principles of information integrity, as well as the healthcare quality aims set forth by the Committee on the Quality of Healthcare in America.

One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is “healthcare processes classification”. The authors found that a typical problem of many European countries is a lack of reliable information in the field of healthcare, mainly because the development of quality instruments, including healthcare processes classification, is not a priority for medical and other health professions. Additionally, it is difficult to update this instrument coherently with organisational changes and developmental achievements. This article describes the approach used by the University Medical Centre in Ljubjana, Slovenia, to redesign its healthcare processes classification in order to improve the quality of healthcare.