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With high public debts and suffering economies after the COVID-19 pandemic, governments will look for ways to promote recovery. Literature substantially reports on the favorable macroeconomic impact of the healthcare sector.

The authors use data on 19 European countries. Over 30 variables are analyzed to find factors that foster or suppress the economic impact of the healthcare sector. The economic impact is thereby expressed through five types of total multipliers, acting as dependent variables. The authors estimate multiple econometric models.

The results indicate factors that intensify or reduce the economic impact of the healthcare sector as they cause the value of one or more economic multipliers to augment or to diminish. Positive effects are expected from the growth of public funds' share in total healthcare expenditure leading to a higher output, income and value-added multipliers. The import multiplier diminishes when expenditure on healthcare as percent of GDP rises. On the other hand, rising expenditure on pharmaceuticals in the share of healthcare expenditure lowers the output multiplier. Rising GDP per capita and higher healthcare systems' technical efficiency cause the employment multiplier to lower.

Policymakers can strengthen the economic impact of the healthcare sector on the national economy. This could be achieved by stimulating factors, being identified in our study. Strengthening the economic impact of the healthcare sector is especially welcomed when fostering economic recovery is needed.

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.

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.

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.

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.

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?

As the prolonged effect of the COVID-19 pandemic has materially impacted investment returns significantly, it is more crucial than ever for institutional investors to redefine their property portfolios using assets with better investment management potential and meaningful diversification benefits. The “alternative asset revolution” is gaining traction in the property investment space internationally among institutional investors due to the shifting investment attitudes towards the alternative property sectors. Australia's $205bn healthcare property sector is at the forefront of this revolution due to its societal significance, as well as its attractive investment qualities. This paper investigates the institutional investor management of the Australian healthcare property sector via both the direct and listed channels and empirically analyses its investment attributes.

Using the unique Morgan Stanley Capital International/Property Council of Australia quarterly data set for Australian direct healthcare property over 2006–2020, the risk-adjusted performance and portfolio diversification potential direct healthcare property and listed healthcare were assessed. A constrained mean-variance portfolio optimisation framework was used to develop a six-asset portfolio scenario to analyse the portfolio added-value benefits of both direct healthcare property and listed healthcare in a mixed-asset investment strategy. A similar set of analysis was performed using the post-global financial crisis (GFC) quarterly time series of 2009–2020 to investigate the healthcare asset class' performance dynamics in the post-GFC investment timeframe.

The results indicate that direct healthcare property and listed healthcare offer two key advantages for institutional investors in managing their property portfolios: (1) a stable yet superior risk-adjusted performance and (2) significant portfolio diversification potential in managing their property portfolios. Importantly, both direct healthcare property and listed healthcare provided valuable contributions in strengthening an investment portfolio's performance. The post-GFC sub-period analysis revealed a consistent conclusion regarding the healthcare asset class's performance attributes.

This is the first research that provides an independent empirical examination of the strategic importance of Australian healthcare property as a maturing alternative property sector that can serve both investment and environmental, social and governance goals of investors. This research presents a positive investment prognosis for the Australian healthcare property sector to achieve its institutionalised status as a mainstream asset class of the future.

Amongst the alternate property sectors, healthcare property has recently become an important property sector for major investors such as pension funds in the global property landscape; particularly in the UK, and being driven by the ageing population demographics. The purpose of this paper is to assess the significance, risk-adjusted performance and portfolio diversification benefits of UK healthcare property in a UK property and mixed-asset portfolio over 2007–2016. Both healthcare property and listed healthcare property channels are assessed. Drivers and risk factors for the on-going development of the healthcare property sector are also identified.

Using annual total returns, the risk-adjusted performance and portfolio diversification benefits of UK healthcare property over 2007–2016 is assessed. An asset allocation diagram is used to assess the role of both healthcare property channels in a UK property portfolio and in a UK mixed-asset portfolio.

Both UK healthcare property and listed healthcare property delivered superior risk-adjusted returns compared to UK property, stocks and listed property over 2007–2016, with portfolio diversification benefits in the fuller mixed-asset portfolio context, but not in a narrower property portfolio context. Importantly, this sees both UK healthcare property channels as strongly contributing to the UK property and mixed-asset portfolios across the entire portfolio risk spectrum and validating the property industry perspective of healthcare property being low risk and providing diversification benefits in a mixed-asset portfolio. However, this was not to the loss or substitution of traditional direct property exposure.

Healthcare property is an alternate property sector that has become increasingly important in recent years. The results highlight the important role of both healthcare property channels in a UK property portfolio and in a UK mixed-asset portfolio. The strong risk-adjusted performance of both UK healthcare property compared to UK property, stocks and listed property sees both UK healthcare property channels contributing to the mixed-asset portfolio across the entire portfolio risk spectrum. This is particularly important, as many investors (e.g. pension funds) now see healthcare property as an important property sector in their overall portfolio; particularly with the ageing population dynamics in most countries. The importance of both healthcare property channels sees healthcare property exposure accessible to both small investors and large investors.

This paper is the first published empirical research analysis of the risk-adjusted performance of UK healthcare property, and the role of healthcare property in a UK property portfolio and in a UK mixed-asset portfolio. This research enables empirically validated, more informed and practical property investment decision-making regarding the strategic role of both healthcare property and listed healthcare property in a portfolio.

High European standards of life quality are declared in a set of legislative documents in Ukraine, but the rewarding policy for the healthcare employees because of the coronavirus disease 2019 (COVID-19) disease remains not fully implemented. The purpose of the study is to develop indicators, standards and methods of assessing rewarding policies for healthcare employees in terms of providing decent labour remuneration that are useful for all stakeholders of the healthcare sector in Ukraine.

The study proposes the methodical foundations of developing evaluation tools of rewarding policies for implementing the decent work concept at the sectoral level.

The findings identify the complex indicator of decent labour remuneration in the healthcare sector in Ukraine, which is 0.185. It proves that the level of the decent labour remuneration of the healthcare employees in Ukraine is at the low level.

The study provides the important recommendations for all policymakers in the healthcare sector in different countries in the context of diagnosing the problems in the rewarding policies and determining the directions for improvement in terms of implementation of the decent work principles.

By proposing and calculating the main methodical foundations of evaluation tools development of rewarding policies in the context of realisation of the decent work concept at the sectoral level, the study fills a void in the decent labour remuneration and the labour economics theory literature.

The purpose of this paper is to examine the factors that triggered the privatisation of Bangladesh’s health sector.

This study follows systematic reviews in its undertaking and is based on an extensive review of both published and unpublished documents. Different search engines and databases were used to collect the materials. The study takes into account of various research publications, journal articles, government reports, policy and planning documents, relevant press reports/articles, and reports and discussion papers from the World Health Organization, the World Bank and the Asian Development Bank.

While Bangladesh’s healthcare sector has undergone an increasing trend towards privatisation, this move has limited benefits on the overall improvement in the health of the people of Bangladesh. The public sector should remain vital, and the government must remobilise it to provide better provision of healthcare.

The paper focusses only on the public policy aspect of privatisation in healthcare of a country.

The paper examines the issue of privatisation of healthcare and concludes that privatisation not only makes services more expensive, but also diminishes equity and accountability in the provision of services. The study, first, makes a spate of observations on improving public healthcare resources, which can be of value to key decision makers and stakeholders in the healthcare sector. It also discourages the move towards private sector interventions.

This study is an independent explanation of a country’s healthcare system. Lesson learned from this study could also be used for developing public policy in similar socio-economic contexts.

Blockchain technology (BCT) has multiple benefits across industries in varied contexts, but limited organizations have adopted such disruptive innovative technologies in the healthcare industry in India. The research on advancing the understanding of blockchain adoption (BCA) determinants in India's healthcare industry is limited. Thus, the study aims to identify the BCA determinants in the healthcare sector in India. Further, the impact of BCA was examined on organizational performance (OP).

The study utilizes Technology, Organization, and Environment (TOE) framework to investigate the determinants of BCA in the healthcare sector in India. The data were gathered using a seven-point Likert seven-point ranging from “strongly agree” to “strongly disagree” from 272 respondents working in the healthcare industry in India. The relationship within the framework was investigated using structural equation modeling.

The results demonstrate the positive impact of top management support, organizational size, organizational readiness, competitive pressure and government support on BCA in the healthcare sector. On the other hand, compatibility, security and privacy issues do not affect BCA. The results emphasize and validate blockchain’s importance in improving OP in the healthcare sector. Further, the results indicate that non-technological factors are paramount to improving BCA within the healthcare sector. Organizations should invest in employee training and development to ensure their staff have the necessary knowledge and skills to effectively manage BCT.

The model was developed for BCA in the healthcare sector in the Indian context; however, the model applies to other countries with the same business environment. Hence, the model can be further examined in diverse countries to generalize the findings.

The study offers valuable insights into the factors that influence BCA and OP in the healthcare sector. The results of this research can be used to inform policy decisions and guide practitioners toward promoting and facilitating the use of BCT in healthcare organizations.

To the best of the author’s knowledge, the present study is the first of its kind to examine the TOE framework in BCA within the healthcare sector and its implications on OP.

Healthcare property has become an important alternate property sector in recent years for many international institutional investors. The purpose of this paper is to assess the risk-adjusted performance, portfolio diversification benefits and performance dynamics of French healthcare property in a French property portfolio and mixed-asset portfolio over 1999–2020. French healthcare property is seen to have different performance dynamics to the traditional French property sectors of office, retail and industrial property. Drivers and risk factors for the ongoing development of the direct healthcare property sector in France are also identified, as well as the strategic property investment implications for institutional investors.

Using annual total returns, the risk-adjusted performance, portfolio diversification benefits and performance dynamics of French direct healthcare property over 1999–2020 are assessed. Asset allocation diagrams are used to assess the role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio. The role of specific drivers for French healthcare property performance is also assessed. Robustness checks are also done to assess the potential impact of COVID-19 on the performance of French healthcare property.

French healthcare property is shown to have different performance dynamics to the traditional French property sectors of office, retail and industrial property. French direct healthcare property delivered strong risk-adjusted returns compared to French stocks, listed healthcare and listed property over 1999–2020, only exceeded by direct property. Portfolio diversification benefits in the fuller mixed-asset portfolio context were also evident, but to a much lesser extent in a narrower property portfolio context. Importantly, this sees French direct healthcare property as strongly contributing to the French property and mixed-asset portfolios across the entire portfolio risk spectrum and validating the property industry perspective of healthcare property being low risk and providing diversification benefits in a mixed-asset portfolio. However, this was to some degree to the loss or substitution of traditional direct property exposure via this replacement effect. French direct healthcare property and listed healthcare are clearly shown to be different channels in delivering different aspects of French healthcare performance to investors. Drivers of French healthcare property performance are also shown to be both economic and healthcare-specific factors. The performance of French healthcare property is also shown to be different to that seen for healthcare property in the UK and Australia. During COVID-19, French healthcare property was able to show more resilience than French office and retail property.

Healthcare property is an alternate property sector that has become increasingly important in recent years. The results highlight the important role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio, with French healthcare property having different investment dynamics to the other traditional French property sectors. The strong risk-adjusted performance of French direct healthcare property compared to French stocks, listed healthcare and listed property sees French direct healthcare property contributing to the mixed-asset portfolio across the entire portfolio risk spectrum. French healthcare property’s resilience during COVID-19 was also an attractive investment feature. This is particularly important, as many institutional investors now see healthcare property as an important property sector in their overall portfolio; particularly with the ageing population dynamics in most countries and the need for effective social infrastructure. The importance of French direct healthcare property sees direct healthcare property exposure accessible to investors as an important alternate real estate sector for their portfolios going forward via both non-listed healthcare property funds and the further future establishment of more healthcare REITs to accommodate both large and small institutional investors respectively. The resilience of French healthcare property during COVID-19 is also an attractive feature for future-proofing an investor’s portfolio.

This paper is the first published empirical research analysis of the risk-adjusted performance, diversification benefits and performance dynamics of French direct healthcare property, and the role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio. This research enables empirically validated, more informed and practical property investment decision-making regarding the strategic role of French direct healthcare property in a portfolio; particularly where the strategic role of direct healthcare property in France is seen to be different to that in the UK and Australia via portfolio replacement effects. Clear evidence is also seen of the drivers of French healthcare property performance being strongly influenced by healthcare-specific factors, as well as economic factors.

Nigeria remains the largest economy in Africa. However, its health sector is described as weak. It continues to battle several challenges ranging from poor health infrastructure, inaccessibility of good quality health care, corruption, substandard drugs circulating, poor funding, shortage of healthcare personnel, high cost of healthcare amidst poverty-stricken masses, among others. The outbreak of Covid-19 and the global oil price crash have further impacted Nigeria’s dwindling healthcare service delivery/indicators. This chapter thus takes stock of the status of the healthcare indicators, healthcare systems, and healthcare governance in Nigeria before and during the Covid-19 pandemic to decipher the impact of the damage caused by Covid-19 on the already weak Nigeria’s health sector. It discusses healthcare indicators, system constraints and responses, and the demand and supply of health care in Nigeria in the era of Covid-19. This chapter shows how Covid-19 has negatively and positively affected the healthcare sector in Nigeria. However, the negative impact remains overwhelming and has potentially grave consequences. This study thus develops a policy framework and time-tested strategy to recover Nigeria’s health sector while factoring in the present capabilities of Nigeria’s health sector. This study thus recommends that adequate infrastructure investment and welfare for healthcare workers are important for the recovery of Nigeria’s health sector.

The purpose of this paper is to analyse the relationship between outpatient satisfaction and the five constructs of healthcare projects’ service quality in Pakistan using Deng’s grey incidence analysis (GIA) model, absolute degree GIA model (ADGIA), a novel second synthetic degree GIA (SSDGIA) model and two approaches of decision-making under uncertainty.

The study proposes a new synthetic GIA model and demonstrates its feasibility on data (N=221) collected from both public and private sector healthcare projects of Punjab, the most populous province of Pakistan, using a self-administered questionnaire developed using the original SERVQUAL approach.

The results of decision analysis approach indicated that outpatients’ satisfaction from the private sector healthcare projects is higher as compared to the public healthcare projects’. The results from the proposed model revealed that tangibility and reliability play an important role in shaping the patient satisfaction in the public and private sectors, respectively.

The study is pioneer in evaluating a healthcare system’s service quality using grey system theory. The study proposes the SSDGIA model as a novel method to evaluate parameters comprehensively based on their mutual association (given by absolute degree of grey incidence) and inter-dependencies (given by Deng’s degree of grey incidence), and tests the new model in the given scenario. The study is novel in terms of its analysis of data and modelling. The study also proposes a comprehensive structure of the healthcare delivery system of Pakistan.