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Health Services Management Research

Federico Lega
No abstract text is available yet for this article.
May 2018: Health Services Management Research
Grazia Antonacci, Julie E Reed, Laura Lennox, James Barlow
Introduction Process mapping provides insight into systems and processes in which improvement interventions are introduced and is seen as useful in healthcare quality improvement projects. There is little empirical evidence on the use of process mapping in healthcare practice. This study advances understanding of the benefits and success factors of process mapping within quality improvement projects. Methods Eight quality improvement projects were purposively selected from different healthcare settings within the UK's National Health Service...
May 2018: Health Services Management Research
Federica Centauri, Pamela Mazzocato, Stefano Villa, Marta Marsilio
Background Lean practices have been widely used by health care organizations to meet efficiency, performance and quality improvement needs. The lean health care literature shows that the effective implementation of lean requires a holistic system-wide approach. However, there is still limited evidence on what drives effective system-wide lean implementation in health care. The existing literature suggests that a deeper understanding of how lean interventions interact with the organizational context is necessary to identify the critical variables to successfully sustain system-wide lean strategies...
May 2018: Health Services Management Research
Gareth H Rees, Peter Crampton, Robin Gauld, Stephen MacDonell
Health workforce planning aims to meet a health system's needs with a sustainable and fit-for-purpose workforce, although its efficacy is reduced in conditions of uncertainty. This PhD breakthrough article offers foresight as a means of addressing this uncertainty and models its complementarity in the context of the health workforce planning problem. The article summarises the findings of a two-case multi-phase mixed method study that incorporates actor analysis, scenario development and policy Delphi. This reveals a few dominant actors of considerable influence who are in conflict over a few critical workforce issues...
May 2018: Health Services Management Research
Martin Powell
The years approaching the 70th anniversary of the British National Health Service (NHS) have seen some re-assessment of the role of the Labour party in general, and Minister of Health, Aneurin Bevan in particular, in the creation of the NHS. It is clear that Bevan casts a long shadow over the NHS. In terms of 'history as invocation', Bevan can be invoked in different ways. Put another way, different Bevans cast a variety of shadows. This article explores: Bevan as the embodiment of the NHS; Bevan as rhetoric; Bevan as trust; and Bevan as reassurance...
May 2018: Health Services Management Research
Anna Romiti, Mario Del Vecchio, Maddalena Grazzini
Recently, most European countries have undergone integration processes through mergers and strategic alliances between healthcare organizations. The present paper examined three cases within the Italian National Health Service in order to determine how different organizations, within differing institutional contexts, govern an healthcare integration process. Furthermore, we explored the possibility that the governance mode, usually seen as alternatives (i.e., merger or alliance), could be considered as a separate step in the development of a more suitable integration process...
May 2018: Health Services Management Research
Federico Lega
No abstract text is available yet for this article.
February 2018: Health Services Management Research
Yoshinori Nakata, Yuichi Watanabe, Hiroto Narimatsu, Tatsuya Yoshimura, Hiroshi Otake, Tomohiro Sawa
The goal of this study is to evaluate the pure impact of the revision of surgical fee schedule on surgeons' productivity. We collected data from the surgical procedures performed by the surgeons working in Teikyo University Hospital from 1 April through 30 September in 2013-2016. We employed non-radial and non-oriented Malmquist model. We defined the decision-making unit as a surgeon with the highest academic rank in surgery. Inputs were defined as (1) the number of doctors who assisted surgery and (2) the time of surgical operation...
February 2018: Health Services Management Research
Christopher P Price, Jane Wolstenholme, Patrick McGinley, Andrew St John
Adoption of new technologies, including diagnostic tests, is often considered not to deliver the expected return on investment. The reasons for this poor link between expectation and outcome include lack of evidence, variation in use of the technology, and an inability of the health system to manage the balance between investment and disinvestment associated with the change in care pathway. The challenges lie in the complex nature of healthcare provision where the investment is likely to be made in the jurisdiction of one stakeholder while the benefits (as well as dis-benefits) accrue to the other stakeholders...
February 2018: Health Services Management Research
Herve Leleu, Mona Al-Amin, Michael Rosko, Vivian G Valdmanis
The objectives of this paper are to use data envelopment analysis to measure hospital inefficiency in a way that accounts for patient outcomes and to study the association between organizational factors, such as hospital-physicians integration level and teaching status, and market competition with hospital inefficiency. We apply the robust data envelopment analysis approach to a sample of private (both not-for-profit and for-profit) hospitals operating in the United States. Our data envelopment analysis model includes mortality and readmission rates as bad outputs and admissions, surgeries, emergency room, and other visits as good outputs...
February 2018: Health Services Management Research
Sean S Huang, Jie Yang, Nathan Carroll
About 60% of the US hospitals are not-for-profit and it is not clear how traditional theories of capital structure should be adapted to understand the borrowing behavior of not-for-profit hospitals. This paper identifies important determinants of capital structure taken from theories describing for-profit firms as well as prior literature on not-for-profit hospitals. We examine the differential effects these factors have on the capital structure of for-profit and not-for-profit hospitals. Specifically, we use a difference-in-differences regression framework to study how differences in leverage between for-profit and not-for-profit hospitals change in response to key explanatory variables (i...
February 2018: Health Services Management Research
Anu Kajamaa, Klaus-Peter Schulz
Background The implementation of innovations in practice is a critical factor for change and development processes in health and home care. We therefore analyze how an innovative tool - a mobility agreement to maintain physical mobility of home care clients - was implemented in Finnish home care. Methods Our study involves ethnographic research of 13 home care visits, two years after the mobility agreement was implemented. We analyze the emergence of contradictions, the motives of the actors and the use of artifacts supporting or inhibiting the implementation...
February 2018: Health Services Management Research
Richard Colbran, Robyn Ramsden, Karen Stagnitti, Samantha Adams
Organisation performance measurement is relevant for non-profit charitable organisations as they strive for security in an increasingly competitive funding environment. This study aimed to identify the priority measures and indicators of organisational performance of an Australian non-government charitable organisation that delivers non-acute health services. Seventy-seven and 59 participants across nine stakeholder groups responded to a two-staged Delphi technique study of a case study organisation. The stage one questionnaire was developed using information garnered through a detailed review of literature...
February 2018: Health Services Management Research
Amber L Stephenson, Nicolette Bell
Prisons are rigidly structured institutions housing-in some cases-violent and unstable residents. To discover the positive job attributes and perceived challenges in this extreme practice environment, we employed exploratory qualitative content analysis on the written-in responses of 269 prison health workers in one state's Department of Corrections. Two researchers independently analyzed and coded the data. Using an iterative process, we categorized the responses into themes and critical underlying meanings...
January 1, 2018: Health Services Management Research
Radhoine Laouer
We mobilize theories of corporate governance and the theory of the social psychology of decision-making small groups to understand the operational process of the public hospital supervisory board. More precisely, we empirically test the mediation relationship of the decision-making process (effort norms, use of knowledge and skills, and conflict cognitive) between its structure (size, the composition, and diversity) and the performance of its roles (strategy, control, and service). A total of 320 questionnaires coming from members of the French public hospital supervisory board were collected...
January 1, 2018: Health Services Management Research
Enrique Casalino, Anne Perozziello, Christophe Choquet, Sonia Curac, Christophe Leroy, Romain Hellmann
Objectives Hospital length of stay (days) and revenues per day (euros) could be different depending on admission mode. To determine the impact of admission mode as a function of clinical pathway, we conducted the present study. DATA SOURCES: We included 159,206 admissions to three academic hospitals during a four-year period. Data were obtained from the electronic system of the hospital trust. Study design A case (through-emergency department)-control (elective (EA)) study was conducted (77,052), matched by age, stay severity and type, disease-related group, and discharge mode...
January 1, 2018: Health Services Management Research
Dennis Guhl, Katharina E Blankart, Tom Stargardt
A patient's perception of the service provided by a health care provider is essential for the successful delivery of health care. This study examines the value created by community pharmacies-defined as perceived customer value-in the prescription drug market through varying elements of service quality. We develop a path model that describes the relationship between service elements and perceived customer value. We then analyze the effect of perceived customer value on customer satisfaction and loyalty. We use data obtained from 289 standardized interviews on respondents' prescription fill in the last six months in Germany...
January 1, 2018: Health Services Management Research
Tanuj Mathur, Gurudas Das, Hemendra Gupta
Most studies have associated "un-affordability" as a plausible cause for the lower take-up of private voluntary health insurance plans. However, others refuted this claim on the pretext that when people can afford "inpatient-care" from pocket then insurance premium cost is far less than those payments. Thus, economic factors remain insufficient in clearly explaining the reason for poor private voluntary health insurance take-up. An attempt is being made by shifting the focus towards non-economic factors and understanding the role of perception and health insurance literacy in transforming people preferences to invest in private voluntary health insurance plans...
January 1, 2018: Health Services Management Research
Sara Barsanti, Manila Bonciani
Healthcare systems have followed several strategies aimed at integrating primary care services and professionals. Medical homes in the USA and Canada, and primary care centres across Europe have collocated general practitioners and other health and social professionals in the same building in order to boost coordination among services and the continuity of care for patients. However, in the literature, the impact of co-location on primary care has led to controversial results. This article analyses the possible benefits of the co-location of services in primary care focusing on the Italian model of primary care centres (Case della Salute) in terms of general practitioners' perception...
January 1, 2018: Health Services Management Research
Stefano Villa, Joseph D Restuccia, Eugenio Anessi-Pessina, Marco Giovanni Rizzo, Alan B Cohen
Italian and American hospitals, in two different periods, have been urged by external circumstances to extensively redesign their quality improvement strategies. This paper, through the use of a survey administered to chief quality officers in both countries, aims to identify commonalities and differences between the two systems and to understand which approaches are effective in improving quality of care. In both countries chief quality officers report quality improvement has become a strategic priority, clinical governance approaches, and tools-such as disease-specific quality improvement projects and clinical pathways-are commonly used, and there is widespread awareness that clinical decision making must be supported by protocols and guidelines...
January 1, 2018: Health Services Management Research
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