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The mass exodus of the professional healthcare workforce has become a cankerworm for a developing nation like Nigeria, and this worsens the already depleted healthcare systems in underdeveloped nation. This study investigated the rationale behind medical workers' brain-drain syndrome and the quality healthcare delivery in the Nigerian public healthcare sector.

To stimulate an understanding of the effect of the phenomenon called brain drain, the study adopted a diagnostic research design to survey the public healthcare personnel in government hospitals. The study administered a battery of adapted research scales of different measures to confirm the variables of interest of this study on a probability sampling strategy. The study surveyed 450 public healthcare sector employees from four government hospitals to gather pertinent data. The study used a structural equation model (SEM) and artificial neural networks (ANNs) to analyse the collected data from the medical personnel of government hospitals.

The findings of this study are significant as postulated. The study discovered that poor quality worklife experienced by Nigerian medical personnel was attributed to the brain-drain effect and poor healthcare delivery. The study further demonstrated that job dissatisfaction suffered among the public healthcare workforce forced the workforce to migrate to the international labour market, and this same factor is a reason for poor healthcare delivery. Lastly, the study discovered that inadequate remuneration and pay discouraged Nigerian professionals and allied healthcare workers from being productive and ultimately pushed them to the global market.

Practically, this study has shown three major elements that caused the mass movement of Nigerian healthcare personnel to other countries of the world and that seems novel given the peculiarity of the Nigerian labour market. The study is original and novel as much study has not been put forward in the public healthcare sector in Nigeria concerning this phenomenon.

Facilities management (FM) professionals state that adopting FM will positively support core service delivery and ensure customer satisfaction. Evidences of such claim are important as it will enhance the rationale for institutionalising prudent FM service quality in hospitals in Ghana. This paper aims to assess the mediating effect of healthcare FM service quality on patients’ satisfaction and overall healthcare delivery.

This is a cross-sectional study involving adult patients at the Physician outpatient departments and Polyclinics of Komfo Anokye, Tamale and Cape Coast Teaching hospitals in Ghana. A questionnaire survey using a well-structured five-point likert scale based on the SERVQUAL dimensions and Healthcare core service dimensions rooted in the FM framework was used to collect data from 660 patients. Smart PLS was used to analyse the data of 622 valid questionnaires.

The study results revealed that FM service quality mediates the relationship between patients’ satisfaction and three of the constructs under core healthcare delivery. That is, (the quality of healthcare delivery, the quality of healthcare personnel and the adequacy of healthcare resources) – surprisingly, the fourth construct (the quality of administration process) was not supported.

There is no or at best very limited studies on the contribution of healthcare FM on patients satisfaction of core healthcare delivery in Ghana. Therefore, this study will enrich and contribute to knowledge in healthcare FM in general and that of a developing African country in particular.

Purpose – The core theme of this paper is that, to provide the best kind of process systems to support a “quality” healthcare provider, it is essential to “engineer‐in” quality as early as possible – effectively at the specification and design phase. It extends to the healthcare context a novel approach, which provides a transparent model of how an envisioned structure delivers services and fulfils stakeholders' needs. Design/methodology/approach – In the paper a new construct, developed by the authors, is described and then extended to the healthcare sector. The underpinning theories of the new construct are discussed and examples for a health care service are presented. Findings – The paper finds that there is a full literature on quality and TQM, but relatively little offers practical tools for supporting design and implementation processes that enhance the likelihood of achieving quality operations. The presentation and discussion of the construct presented argue that the approach presented here can achieve this aim. Practical implications – In the paper, as with many ventures, organisations charged with healthcare delivery are presently facing the dual challenges of seeking to satisfy widely extended stakeholder groups and implement complex ICT systems to support e‐fulfilment. To ensure that quality is “engineered‐in”, a holistic, integrated and quality approach is required, and Total Quality Management (TQM) principles are the obvious foundations for this. Originality/value – The paper shows that electronically delivered information and funds transaction systems do offer healthcare organisations great potential, but many large integrated ICT systems have notoriously disappointed the stakeholder health care service. An integrative view of the delivery system design, based on the literature from strategic management, business process design, e‐business design, and TQM, has yielded a unique construct, which integrates these views in a transparent model readily accessible to the various domain experts. The specific role of this in healthcare fulfilment system design applications is demonstrated.

The purpose of this paper is to propose and test a healthcare framework of service quality, perceived value, and satisfaction in Ghana. More specifically, this study investigates the role and effect of service quality on patient satisfaction and perceived value in Ghana’s healthcare delivery.

Data were gathered through surveys administered to 113 healthcare patients in Ghana. partial least square-structural equation modeling analysis was used to empirically test the research model.

Results show healthcare quality significantly influences satisfaction and perceived value of healthcare delivery. Additionally, perceived value’s impact on satisfaction and behavioral intention shows that increasing perceived benefits while reducing perceived costs leads to repeat behavior and paves the way for retention strategy for healthcare management.

This study yields a series of limitations in its results and conclusions. These limitations and future research are discussed in Section 7 of the study.

This study contributes to the literature by examining the effects of healthcare service quality on patient satisfaction and perceived value, determining the effect of healthcare service quality on patients’ behavioral intention, and testing the proposed framework in Ghana, a fast growing and economically liberalized emerging country in Sub-Saharan Africa.

The purpose of this paper is to identify if aspects of organizational culture may indicate a new terrain in the cultural influences‐quality healthcare relationship. This research stems from the author's belief that viewing the role of head of department or directorate as pivotal to health care management is critical to health care planning and quality healthcare delivery.

Interviews were undertaken among 50 professional clinician and non‐clinician managers working in the role of head of department, in acute care hospitals in Ireland. The sample was drawn from the total population of 850 managers, utilized in a previous survey study.

Organizational culture is more complex than was previously thought. Several cultural influences such as excellence in care delivery, ethical values, involvement, professionalism, value‐for‐money, cost of care, commitment to quality and strategic thinking were found to be key cultural determinants in quality care delivery.

Health care managers perceive that in order to deliver quality focused care they need to act in a professional, committed manner and to place excellence at the forefront of care delivery, whilst at the same time being capable of managing the tensions that exist between cost effectiveness and quality of care. These tensions require further research in order to determine if quality of care is affected in a negative manner by those tensions.

Originality relates to the new cultural terrain presented in this paper that recognizes the potential of health service managers to influence the organizations' culture and through this influence to take a greater part in ensuring that quality health care is delivered to their patients. It also seems to be important that value‐for‐money is viewed as an ethical means of delivering healthcare, and not as a conflict between quality and cost.

The purpose of this paper is to explore the influence of health system factors on access to a quality healthcare among prisoners in Ghana.

Data were gathered using different qualitative methods (interviews and participant observation) with staff of the James Camp Prison, Accra. Findings were analyzed using a framework method for the thematic analysis of the semi-structured interview data; and interpreted with the theoretical perspective of health systems thinking and innovation.

The study concludes that health system factors such as inadequate funding for health services, lack of skilled personnel and a paucity of essential medical supplies and drugs negatively affected the quality of healthcare provided to inmates.

The limited facilities available and the sample size (healthcare workers and prison administrators) impeded the achievement of varied views on the topic.

The paper recommends the need for health policy makers and authorities of the Ghana Prison Service to collaborate and coordinate in a unified way to undertake policy analysis in an effort to reform the prisons healthcare system.

The national health insurance scheme was found to be the financing option for prisoners’ access to free healthcare with supplementation from the Ghana Prison Service. The study recommends that policy makers and healthcare stakeholders should understand and appreciate the reality that the provision of a quality healthcare for prisoners is part of the entire system of healthcare service delivery in Ghana and as such should be given the needed attention.

This is one of few studies conducted on male only prisoners/prison in the context of Ghana. It recommends the need for an integrated approach to ensure that the entire healthcare system achieves set objectives in response to the primary healthcare concept.

The purpose of this paper is to understand and compare the level of patient’s expectations of healthcare services and their perceived performance. The paper also provides insights into the specific service factors and quality of hospital services which are required to meet the needs of Indian patients.

A total of 210 exit interviews were conducted using a structured questionnaire addressing the probable factors of quality related to healthcare services in a five-point Likert scale. The survey was conducted among the patients recently discharged and about to be discharged from private hospitals of Delhi and NC. A set of questionnaires is administered to collect responses on expected and perceived service qualities.

The paper reviews and discusses the importance of service quality for Indian patients using the SERVQUAL gap model as the measure of service quality. The results gave an overview of the perspectives of Indian patients on the quality of service in private hospitals. Patients indicated best satisfaction in some dimensions of services, namely, the tangible dimension of “hospitals provide ample parking spaces,” empathy dimension of “Doctors are never too busy to respond to my request”, assurance dimension of “I can depend on Doctor/Nurse,” and in the responsiveness dimension of “employees always communicate truly” on hospital matters.

The first limitation is in the scope of sample, that is research findings are limited to Delhi. The second limitation is that the research should have been done in two parts, that is by contacting the patient before they take the services and after the service encounter. Third limitation – for a better understanding, the analysis should have been performed on the gap between the patient’s perception and the perception of the medical service provider about the customer’s perception.

This research would be beneficial to healthcare organizations to do their best to achieve greater patient satisfaction. The findings of the paper that, for all dimensions, the patient’s perception is always higher than the expectation suggests that in the Indian healthcare segment, there is a need of dissemination of information regarding the most modern medical facilities.

This current research is concluded with the suitability of a model that can be used to find the levels of patient satisfaction for healthcare services. The present study is based on primary data and offers a systematic procedure that could form the cornerstone for providing further insights into the conceptual and empirical comprehension of patients perceived service quality and its constituents. The current emergency medicine patient’s service dilemmas are a complex interaction of patients and physician factors specifically targeting efficiency and patient satisfaction. The awareness of these issues particular to the emergency patient can help to maximize efficiency, minimize subsequent medico-legal risk and improve patient care if a tailored management plan is formulated.

The purpose of this paper is to explore regulation in India’s healthcare sector and makes recommendations needed for enhancing the healthcare service.

The literature was reviewed to understand healthcare’s regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS).

Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges.

This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach).

Healthcare pitfalls across the world seem to follow similar follies. India’s complexity and experience is useful for emerging and developed economies.

The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient’s perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

The purpose of this paper is to develop and test a new public healthcare patient satisfaction index (PSI) in Indonesia. More clearly, the index measures overall patient satisfaction and its determinants.

Literature review was performed to identify the determinants of patient satisfaction. Data collection was carried out by using survey with questionnaire. The survey involves 161 patients of one public healthcare service institution in Tangerang, Indonesia. The authors conducted some statistical analyses, namely exploratory factor analysis, Cronbach α analysis, and multiple regression analysis.

A new public healthcare PSI was developed and tested. The index consists of overall patient satisfaction and its determinants. The determinants include the quality of healthcare delivery, the quality of healthcare personnel, the adequacy of healthcare resources, the quality of administration process, perceived value, perceived sacrifice, and image. Furthermore, the new index was called as IPHSI-PSB.

This research was carried out only in Tangerang, Indonesia and only involved one public healthcare service. Hence, the index needs to be tested in different cities in Indonesia. Furthermore, it is also needed to involve more public healthcare service institutions in future researches.

Public healthcare service managers can use IPHSI-PSB to monitor, measure, and improve the patient satisfaction of the public healthcare service institution they manage.

This paper has developed and tested a new public healthcare patient satisfaction index.

This paper aims to explore patients' satisfaction with access to treatment in both the public and private healthcare sectors in London.

Qualitative and quantitative methods were employed to determine patients' levels of satisfaction. A semi‐structured face ‐to‐face non‐probability quota sampling and a probability sample drawn from multistage cluster sampling methods were employed.

The results revealed varying access experiences among public and private care users. Public, as opposed to private, healthcare users experience unsatisfactory outcomes in relation to service climate factors (e.g. getting attention from doctors, time taken to get appointments, access to core treatment and opening hours). Overall, while women are more disadvantaged by spatial accessibility to treatment than men, both public and private healthcare users indicate major problems in accessing healthcare despite the myriad intervention strategies aimed at ameliorating the situation in both sectors. Therefore, access‐to‐care problems are significant and need to be addressed by managers and healthcare providers in order to improve the quality of service delivery and patient satisfaction. Private care users fare better than public users in obtaining medical care at short notice, having more agreeable opening hours for treatment and getting appointments for treatment with less difficulty.

Whereas the limitation of the study was due to its small sample size, it nevertheless will stimulate insight into further academic endeavours.

Academics and practitioners will find the results very useful when making decisions about healthcare provisions and how they can best meet user/patient satisfaction.

This study is significant in drawing on the current literature on satisfaction which is usefully applied to evaluate patients' response to the quality management initiatives in the healthcare sector.