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1 – 10 of 238Juri Matinheikki, Katie Kenny, Katri Kauppi, Erik van Raaij and Alistair Brandon-Jones
Despite the unparalleled importance of value within healthcare, value-based models remain underutilised in the procurement of medical devices. Research is needed to understand…
Abstract
Purpose
Despite the unparalleled importance of value within healthcare, value-based models remain underutilised in the procurement of medical devices. Research is needed to understand what factors incentivise standard, low-priced device purchasing as opposed to value-adding devices with potentially higher overall health outcomes. Framed in agency theory, we examine the conditions under which different actors involved in purchasing decisions select premium-priced, value-adding medical devices over low-priced, standard medical devices.
Design/methodology/approach
We conducted 2 × 2 × 2 between-subjects scenario-based vignette experiments on three UK-based online samples of managers (n = 599), medical professionals (n = 279) and purchasing managers (n = 449) with subjects randomly assigned to three treatments: (1) cost-saving incentives, (2) risk-sharing contracts and (3) stronger (versus weaker) clinical evidence.
Findings
Our analysis demonstrates the harmful effects of intra-organisational cost-saving incentives on value-based purchasing (VBP) adoption; the positive impact of inter-organisational risk-sharing contracts, especially when medical professionals are involved in decision-making; and the challenge of leveraging clinical evidence to support value claims.
Research limitations/implications
Our results demonstrate the need to align incentives in a context with multiple intra- and inter-organisational agency relationships at play, as well as the difficulty of reducing information asymmetry when information is not easily interpretable to all decision-makers. Overall, the intra-organisational agency factors strongly influenced the choices for the inter-organisational agency relationship.
Originality/value
We contribute to VBP in healthcare by examining the role of intra- and inter-organisational agency relationships and incentives concerning VBP (non-) adoption. We also examine how the impact of such mechanisms differs between medical and purchasing (management) professionals.
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Veronika Šlapáková Losová and Ondřej Dvouletý
The resource crisis in healthcare can be alleviated by engaging external stakeholders and resources in healthcare delivery. The authors use value and open innovation concepts to…
Abstract
Purpose
The resource crisis in healthcare can be alleviated by engaging external stakeholders and resources in healthcare delivery. The authors use value and open innovation concepts to understand what motivates the stakeholders to join the healthcare innovation ecosystem and what value such an ecosystem brings to healthcare.
Design/methodology/approach
A systematic literature review following the PRISMA framework method was applied to reach the research objective. Out of a total of 509 identified articles published till 2021, 25 were selected as relevant for this review.
Findings
Six categories of actors were identified, including innovation intermediaries, which were so far neglected in the healthcare innovation literature. Furthermore, patients, healthcare providers, innovation suppliers, investors and influencers were described. The authors also distinguished internal and external stakeholders. The authors show why and how open innovation projects contribute to involving external stakeholders and resources in healthcare delivery by contributing to patient autonomy, relationship building, knowledge transfer, improving collaborative mindset and culture, advancing know-how and bringing additional finances.
Originality/value
This article is the first one to systematically describe the value of open innovation in healthcare. The authors challenge the positivist approach in value presented by value-based healthcare. The authors show how openness contributes to addressing the resource crisis by involving new stakeholders and resources in the care delivery process.
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At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…
Abstract
At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.
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Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the…
Abstract
Purpose
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.
Design/methodology/approach
Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.
Findings
The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.
Originality/value
There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.
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Noor Fadzlina Mohd Fadhil, Say Yen Teoh, Leslie W. Young and Nilmini Wickramasinghe
This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive…
Abstract
Purpose
This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive care performance.
Design/methodology/approach
A case study method was adopted to examine how a hospital integrates its limited resources which leads to the need for resource bundles and an understanding of IS capabilities development to understand how they contribute to the delivery of preventive care in a Malaysian hospital.
Findings
This research proposes a comprehensive framework outlining resource-bundling and IS capabilities development to improve preventive care.
Research limitations/implications
We acknowledge that the problem of transferring and generalizing results has been a common criticism of a single case study. However, our objective was to enhance the reader’s understanding by including compelling, detailed narratives demonstrating how our research results offer practical examples that can be generalized theoretically. The findings also apply to similar-sized public hospitals in Malaysia and other developing countries, facing challenges like resource constraints, HIS adoption levels, healthcare workforce shortages, cultural and linguistic diversity, bureaucratic hurdles, and specific patient demographics and health issues. Further, lessons from this context can be usefully applied to non-healthcare service sector domains.
Practical implications
This study provides a succinct strategy for enhancing preventive care in Malaysian public hospitals, focusing on system integration and alignment with hospital strategy, workforce diversity through recruitment and mentorship, and continuous training for health equity and inclusivity. This approach aims to improve resource efficiency, communication, cultural competence, and healthcare outcomes.
Social implications
Efficiently using limited resources through HIS investment is essential to improve preventive care and reduce chronic diseases, which cause approximately nine million deaths annually in Southeast Asia, according to WHO. This issue has significantly impacted the socioeconomic development of developing countries.
Originality/value
This research refines resource orchestration theory with new mechanisms for resource mobilization, extends IS literature by identifying how strategic bundling forms specialized healthcare IS capabilities, enriches preventive care literature through actionable resource-bundling activities, and adds to HIS literature by advocating for an integrated, preventive care focus from the alignment of HIS design, people and institutional policies to address concerns raised by other research regarding the utilization of HIS in improving the quality of preventive care.
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Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide…
Abstract
Purpose
Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.
Design/methodology/approach
Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).
Findings
The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.
Originality/value
Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.
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This paper aims to explore the antecedents and consequences of service chain flexibility (SCF) in healthcare service delivery.
Abstract
Purpose
This paper aims to explore the antecedents and consequences of service chain flexibility (SCF) in healthcare service delivery.
Design/methodology/approach
A structural model was developed based on a literature review. A 29-indicator questionnaire was circulated among service providers in the healthcare system across India, and 253 valid responses were received, corresponding to a response rate of 46%. The research model was assessed using a cross-sectional research design, and the data were analyzed by structural equation modeling using analysis of moment structures (AMOS) software.
Findings
Service orientation (SO), technology integration (TI), knowledge sharing (KS) and supply chain integration (SCI) were identified as antecedents of SCF, the consequence of which is responsiveness in service delivery (RSD). Furthermore, patient-centered care moderates the relationship between SCF and RSD.
Research limitations/implications
This paper highlights the impact of SCF on RSD in healthcare organizations. Consideration of the four constructs of SO, TI, KS and SCI as antecedents of SCF and, in turn, RSD may be one of the limitations. Future work may identify other theoretical constructs with potential impacts on SCF and RSD. Furthermore, eight months for data collection could have resulted in early-late response bias. This study was operationalized in India and may reflect political, economic, social, technological, environmental and legal factors unique to India.
Practical implications
The study provides suggestions to practitioners for building RSD by leveraging SO, TI, KS and SCI in flexibility-driven service chain processes. Recognizing the relationships among these constructs can aid in the timely formulation of corrective actions and patient-centric policies.
Social implications
This paper highlights how focusing on a SCF can promote RSD. This understanding may aid the design of processes that develop patient-centricity and deliver health as a social good in an effective manner.
Originality/value
The empirical evidence from this study can help hospitals integrate and build flexibility in their functions, thus enabling them to deliver responsiveness in care.
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Shivam Gupta, Sachin Modgil, Ana Beatriz Lopes de Sousa Jabbour, Issam Laguir and Rebecca Stekelorum
Over the last two decades, most organizations have considered technologies to drive digital transformation, and the recent pandemic has brought significant changes in the…
Abstract
Purpose
Over the last two decades, most organizations have considered technologies to drive digital transformation, and the recent pandemic has brought significant changes in the healthcare sector. Therefore, this study explores the technological nexus in supporting digital transformation as a process to govern the healthcare sector more effectively.
Design/methodology/approach
This study uses quantitative and qualitative methods to analyse the impact of ArogyaSetu (a health and wellness app) on India’s digital transformation process. The study involves 212 responses to understand how the app enables digital transformation and its impact on governance, healthcare systems and stakeholders. Additionally, 31 semi-structured interviews were conducted to validate the quantitative study’s findings.
Findings
Referring quantitative part of research design, ArogyaSetu has had a positive impact on the digital transformation of India’s healthcare industry, which has in turn affected stakeholders and improved governance. Moreover, qualitative findings suggest that a governance system like ArogyaSetu can aid in the development of dynamic capabilities within the healthcare system and governance.
Originality/value
This study adds to our understanding of the digital transformation of healthcare by examining it through the lens of dynamic capability. In this framework, “sense” refers to the stakeholders, “seize” the healthcare system and “transform” governance. The study also provides practical implications for managers, academics and government administrators responsible for digital healthcare transformation.
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Karthik Padamata and Rama Devi Vangapandu
The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between…
Abstract
Purpose
The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between both the groups.
Design/methodology/approach
Authors have referred to the Victorian patient satisfaction monitoring (VPSM) scale and studied the responses of 327 patients and 327 employees collected from six private Indian tertiary care hospitals. SPSS v26 software was used to conduct the data reliability test, descriptive analysis and Mann–Whitney U test.
Findings
Authors have found significant differences in perceptions of quality of care between the patients and employees in the Indian hospitals. Employees have high positive perceptions towards the provided medical care whereas the patients have less favourable perceptions for many quality indicators.
Practical implications
This study findings help the healthcare managers, practitioners and healthcare workers of the Indian hospitals to understand the perceptions of both the employees and the patients towards healthcare quality elements and help to reduce the existing perceptual gap in the process of providing quality healthcare services.
Originality/value
To the best of authors knowledge, this is one of the pioneering studies conducted in Indian healthcare industry to capture and compare the perceptions of both the employees' and the patients' perceptions of various quality of care elements. This study highlighted the existing perceptual gap between the employees and the patients on various healthcare quality elements and indicated the critical areas for improvement to provide high quality healthcare services.
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