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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.

This study aims to summarize studies that compared the performance of health-care institutions led by leaders with medical background versus those with no medical background.

A systematic search was conducted on three databases: PubMed, Ovid Medline and Google Scholar to identify relevant peer-reviewed studies using the keywords “performance,” “impact,” “physician,” “medical,” “doctor,” “leader,” “healthcare institutions” and “hospital.” Only quantitative studies that compared the performance of health-care institutions led by leaders with medical background versus non-medical background were included. Articles were screened and assessed for eligibility before the relevant data were extracted to summarize, appraise and make a narrative account of the findings.

A total of eight studies were included, four were based in the USA, two in the UK and one from Germany and one from the Arab World. Half of the studies (n = 4) reported overall better health-care institutional performance in terms of hospital quality ranking such as clinical effectiveness and patient safety under leaders with medical background, whereas one study showed poorer performance. The remaining studies reported mixed results among the different performance indicators, especially financial performance.

While medical background leaders may have an edge in clinical competence to manage health-care institutions, it will be beneficial to equip them with essential management skills to optimize leadership competence and enhance organizational performance.

The exclusive inclusion of quantitative empirical studies that compared health-care institutional performance medical and non-medical leaders provides a clearer link between the relationship between health-care institutional performance and the leaders’ background.

This works provides a thorough understanding of the challenges and opportunities associated with Additive Manufacturing (AM) adoption in the medical sector. Through this analysis, we aim to better understand when to adopt AM, how to do so, and how such adoption might change in the future.

This research first conducted a systematic literature review (SLR) to identify AM challenges and opportunities in the medical sector, which were then validated through a Delphi study. The 18 Delphi study participants were also asked to suggest countermeasures for the challenges and help identify future AM adoption scenarios. Finally, these findings were analyzed according to the ecosystem pie model to design an ecosystem model for AM in the medical sector.

Among the 13 challenges and 13 opportunities identified, the lack of a skilled workforce and the responsiveness achievable via AM were by far the most relevant challenge and opportunity. Moreover, the participants identified countermeasures for 10 challenges, as well as three future AM adoption scenarios. Finally, leveraging these findings, an ecosystem model was developed.

This work contributes to the limited understanding of the AM challenges and opportunities in the medical sector. It helps medical practitioners to better understand the challenges and opportunities associated with AM and AM manufacturers to better identify where to focus their R&D efforts and how this would impact future AM adoption levels. Furthermore, this work extends current theory supporting the design of an ecosystem model for AM in the medical sector following the ecosystem pie model.

This paper examines the factors that influence behavioral intention in the context of medical tourism in Türkiye. With the growing popularity of Türkiye as a destination for medical tourism, it is essential to understand the key determinants influencing individuals’ intention to engage in medical tourism activities.

This study used the Extended Theory of Planned Behavior (E-PBT) variables, which include attitude, subjective norm and perceived behavioral control, to measure their influence on behavioral intention. In addition, a customer experience scale was used to assess the influence of dimensions such as education, entertainment, aesthetics and escapism on behavioral intention. The research instrument was validated by expert review, and data were collected using purposive sampling. A total of 420 surveys were deemed suitable for analysis.

The path analysis revealed that attitudes and perceived behavioral control positively impacted behavioral intention within the domain of medical tourism in Türkiye. Conversely, subjective norms did not have a significant positive effect on behavioral intention. Furthermore, it was observed that the dimensions of entertainment, escape and aesthetics positively affected behavioral intention. However, education and aesthetics did not significantly influence behavioral intentions.

The results of this paper have practical implications for marketers and policymakers in the medical tourism industry in Türkiye. Understanding the factors that drive individuals’ behavioral intentions can assist in developing effective marketing strategies to attract and serve potential medical tourists. Medical tourism providers can enhance their services by optimizing attitudes and perceived behavioral control while emphasizing entertainment and escapism for their clientele.

This research focuses on uncovering factors influencing individuals’ behavioral intentions in medical tourism in Türkiye. Using the E-PBT framework and exploring the dimensions of the customer experience scale, this study aimed to understand the driving forces behind individuals’ decisions to engage in medical tourism.

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.

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.

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.

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.

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.

The purpose of this mixed-methods study was to explore how medical secretaries experience digital transformation in a Swedish healthcare organisation, with a focus on workplace climate and health.

Data were collected using a sequential exploratory mixed-methods design based on grounded theory, with qualitative data collection (a Quality Café and individual interviews) followed by quantitative data collection (a questionnaire).

Four categories with seven underlying factors were identified, emphasising the crucial need for effective organisation of digital transformation. This is vital due to the increased knowledge and skills in utilising technology. The evolving roles and responsibilities of medical secretaries in dynamic healthcare settings should be clearly defined and acknowledged, highlighting the importance of professionality. Ensuring proper training for medical secretaries and other occupations in emerging techniques is crucial, emphasising equal value and knowledge across each role. Associations were found between some factors and the health of medical secretaries.

This study adds to the knowledge on digital transformation in healthcare by examining an important occupation. Most data were collected online, which may be a limitation of this study.

Several aspects of the medical secretaries’ experiences were identified. Knowledge of these is valuable for healthcare managers to make digital transformation more effective while avoiding excessive strain on medical secretaries.

Medical secretaries are expected to contribute to the digitalisation of healthcare. However, minimal research has been conducted on the role of medical secretaries in workplace digitalisation, focusing on workplace roles and its dynamics.

Applying the value-attitude-behavior (VAB) model, this study investigated how perceived utilitarian and hedonic values (i.e. novelty and emotion) affect individuals' attitudes toward medical hotels and how these attitudes, in turn, influence their intentions to stay at medical hotels. The current study also explored the moderating impact of overall health status on the relationships between perceived utilitarian, novelty and emotional values and attitudes toward medical hotels.

The data collected from 351 individuals who spent a night in a hospital to undergo medical treatment was used in conducting structural equation modeling to evaluate the research model and test the study hypotheses.

The study results revealed that perceived utilitarian, novelty and emotional values exerted a positive influence on individuals’ attitudes toward medical hotels, consequently enhancing their intention to stay. Additionally, significant moderating impacts of overall health status on the associations between perceived utilitarian, novelty and emotional values and attitudes toward medical hotels were observed.

The study findings provide useful guidance for professionals, such as operators, marketers and managers in medical hotels. These insights can improve operational and marketing strategies, benefiting both the industry and healthcare accommodation seekers.

This study is among the first to empirically assess a theoretical model that explored the influence of individuals' value perceptions within the realm of medical hotel establishments.

This study aims to investigate the influence of cognitive and affective trust on the revisit intention of medical tourists to a developing country like India, focusing on the role of country image as a moderator.

This study used partial least square-based structural equation modelling to test the hypotheses using data from 297 medical tourists visiting India from abroad for treatment.

The findings of this study confirmed that all the dimensions of cognitive trust, namely, perceived expertise, performance and reputation of the health-care service providers, have a positive and significant impact on the revisit intention of medical tourists to India. In contrast, none of the two dimensions of affective trust have a significant effect on the revisit intention of medical tourists to India. This study also confirmed that country image significantly moderates the relationship between performance dimensions of cognitive trust and medical tourists’ revisit intention to India.

The study’s findings have significant theoretical and managerial implications as they explore the effect of cognitive and affective trust on medical tourists’ the revisit intention to visit an emerging economy, considering the country’s image as a moderator.

本研究旨在调查认知和情感信任对印度等发展中国家医疗游客重游意愿的影响, 重点关注国家形象的调节作用。

本研究采用基于偏最小二乘的结构方程模型, 使用 297 名从国外到印度接受治疗的医疗游客的数据来检验假设。

本研究的结果证实, 认知信任的所有维度, 即医疗服务提供者的专业知识、绩效和声誉, 对印度医疗游客的重游意愿产生积极且显着的影响。相比之下, 情感信任的两个维度都没有对印度医疗游客的重游意愿产生显着影响。这项研究还证实, 国家形象显着调节认知信任绩效维度与医疗游客重访印度意愿之间的关系。

该研究的结果具有重要的理论和管理意义, 因为他们探讨了认知和情感信任对医疗游客重访新兴经济体的意愿的影响, 并考虑到该国作为调节者的形象。

Este estudio tiene como objetivo investigar la influencia de la confianza cognitiva y afectiva en la intención de volver a visitar a un país en desarrollo como la India por parte de turistas médicos, centrándose en el papel de la imagen del país como moderador.

Este estudio empleó un modelo de ecuaciones estructurales parcial basado en mínimos cuadrados para probar las hipótesis utilizando datos de 297 turistas médicos que visitaron la India desde el extranjero para recibir tratamiento.

Los hallazgos de este estudio confirmaron que todas las dimensiones de la confianza cognitiva, es decir, la experiencia percibida, el desempeño y la reputación de los proveedores de servicios de atención médica, tienen un impacto positivo y significativo en la intención de volver a visitar a la India por parte de los turistas médicos. Por el contrario, ninguna de las dos dimensiones de la confianza afectiva tiene un efecto significativo en la intención de volver a visitar la India por parte de los turistas médicos. Este estudio también confirmó que la imagen del país modera significativamente la relación entre las dimensiones de desempeño de la confianza cognitiva y la intención de los turistas médicos de volver a visitar la India.

Los hallazgos del estudio tienen importantes implicaciones teóricas y administrativas, ya que exploran el efecto de la confianza cognitiva y afectiva en la intención de los turistas médicos de visitar una economía emergente, considerando la imagen del país como moderador.

The European Union (EU) Medical Device Regulations (MDR) 2017/745 entered into force on May 2021 with changes related to strengthening the clinical evaluation requirements, particularly for high-risk devices. This study aims to investigate the impact of these strengthened requirements on medical device manufacturers by investigating the challenges they encounter while generating an MDR-compliant clinical evaluation report.

A systematic literature review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method of peer-reviewed literature and various government jurisdictional reports and legislation.

The findings from the study understanding what constitutes sufficient clinical evidence poses the biggest challenge to the generation of an MDR-compliant clinical evaluation report. Resulting from the challenges they are facing, manufacturers of certain CE-marked medical devices are planning to remove (and have removed) devices from the EU market upon expiration of their certificate, and in the case of new and innovative devices, some manufacturers are planning to launch in other markets ahead of the EU. These challenges will lead to a potential shortage of certain medical devices in the EU and a delay in access to new devices, thereby negatively impacting patients’ quality of life.

This study provides a unique insight into the challenges currently experienced by medical device manufacturers as they transition to the MDR clinical evaluation requirements and the subsequent impact on the continued availability of medical devices in the EU. A limitation is the lack of literature analysing the regulations and their effects.

This study has both theoretical contributions in that, to the best of the authors’ knowledge, it is the first detailed and systematic review of the new MDR Regulations and has implications for practice as manufacturers and policymakers can leverage it alike to understand the challenges of the new MDR.

Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present.

A customised audit tool was created using Sphinx software. Data were collected for three months. All wards included in the study were visited once during four discrete time periods across the working week. The medical records trolley’s location was noted and total unattended medical records, total unattended nursing records, total unattended patient lists and when nursing personnel, medical students, public and a ward secretary were visibly present were recorded.

During 84 occasions when the authors visited wards, unattended medical records were identified on 33 per cent of occasions, 49 per cent were found during weekend visiting hours and just 4 per cent were found during morning rounds. The unattended medical records belonged to patients admitted to a medical specialty in 73 per cent of cases and a surgical specialty in 27 per cent. Medical records were found unattended in the nurses’ station with much greater frequency when the ward secretary was off duty. Unattended nursing records were identified on 67 per cent of occasions the authors visited the ward and were most commonly found unattended in groups of six or more.

This study is a timely reminder that confidential patient information is at risk from inappropriate disclosure in the hospital. There are few context-specific standards for data protection to guide healthcare professionals, particularly paper records. Nursing records are left unattended with twice the frequency of medical records and are found unattended in greater numbers than medical records. Protection is strongest when ward secretaries are on duty. Over-reliance on vigilant ward secretaries could represent a threat to confidential patient information.

While other studies identified data protection as an issue, this study assesses how data security varies inside and outside conventional working hours. It provides a rationale and an impetus for specific changes across the whole working week. By identifying the on-duty ward secretary’s favourable effect on medical record security, it highlights the need for alternative arrangements when the ward secretary is off duty. Data were collected prospectively in real time, giving a more accurate healthcare record security snapshot in each data collection point.