Reimbursement scheme for China’s public hospitals from perspective of stakeholders

2019 ◽  
Vol 13 (4) ◽  
pp. 918-938
Author(s):  
Qiwen Jiang ◽  
Xiaojing Luo ◽  
Sibo Wang ◽  
Shi-Jie (Gary) Chen
Keyword(s):  
Health Care ◽  
Social Organization ◽  
Medical Service ◽  
Econometric Models ◽  
Public Hospitals ◽  
Reimbursement System ◽  
Content Type ◽  
Four Dimensions ◽  
Fixed Assets ◽  
Reimbursement Scheme

Purpose Public hospitals in China usually rely on revenues from medical services and medications to compensate for major costs given their nonprofit nature. The lack of government subsidies and unreasonable prices of medical services have led to high medical costs and unbalanced reimbursement system for public hospitals. There is a critical need of research on improvement of reimbursement system that will create positive effect on China’s health-care system. This paper aims to focus on four dimensions of stakeholders (government, patients, medical insurance agencies and social organization) and six major expenditures to explore reimbursement scheme for public hospitals in China with the purpose of relieving unbalanced income and expenditure of hospitals, avoiding medication markups and reducing medical expenses from patients. Design/methodology/approach In this paper, the authors study reimbursement scheme for public hospitals from the perspective of four dimensions of stakeholders and how stakeholders reimburse six major expenditures of hospitals. A total of 128 effective samples were collected from financial data of 32 public hospitals through 2009-2012. This paper analyzes the econometric models of the selected revenue and expenditure. This paper analyzes the econometric models of the selected revenue and expenditure using linear regression. The linear relationship between each cost and different types of incomes (i.e. reimbursements from government, patients, insurance agencies and social organization) is analyzed before and after cancelling the medication markups. Findings Results from empirical research verify that government reimbursement is insufficient, and using medication markups to compensate for medical service costs has become a serious problem for China’s public hospitals. To avoid the medication markups and improve the reimbursement scheme, government should reimburse labor cost, fixed assets cost and research cost; patients and medical insurance agencies should reimburse the costs of medical service, medication and administration/operations; and social organization should supplement the fixed assets cost. Originality/value In this study, the authors defined and classified stakeholders of reimbursement scheme for public hospitals in China, which help understand the roles and effects that different stakeholders can play in compensation. Along with the proposed reimbursement scheme framework, this study will help make effective implementation of new health-care reform program in China.

Linking authentic leadership and management capability to public hospital performance: the role of work engagement

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammed Aboramadan ◽  
Main Naser Alolayyan ◽  
Mehmet Ali Turkmenoglu ◽  
Berat Cicek ◽  
Caterina Farao
Keyword(s):  
Health Care ◽  
Work Engagement ◽  
Authentic Leadership ◽  
Hospital Performance ◽  
Public Hospitals ◽  
Mediation Effect ◽  
Leadership And Management ◽  
Content Type ◽  
Management Capability ◽  
The Impact

Purpose This paper aims to propose a model of the effect of both authentic leadership and management capability on hospital performance. This model proposes work engagement as an intervening mechanism between the aforesaid links. Design/methodology/approach Data were collected from 380 medical staff working in Jordanian Public hospitals and were analysed using the structural equation modelling analysis technique. Findings The results suggest that both authentic leadership and management capability have a positive effect on hospital performance. Although positive, the direct effect of management capability on performance was not significant. Furthermore, work engagement demonstrated to play a full mediation effect between management capability and hospital performance and a partial mediation effect between authentic leadership and hospital performance. Practical implications This study may be of use for public medical services providers in general and other services sectors in terms of the role authentic leadership and management resources can play in contributing to positive work-related outcomes at the individual and organisational levels. Originality/value Considering the mainstream literature in health-care management, to the best of the authors’ knowledge, this is the first study to date to integrate the impact of both authentic leadership and management capabilities in the public health-care sector. Further, the research model has not previously been introduced when taking into account the role that work engagement can play between the examined variables.

The impact of job security, job satisfaction and job embeddedness on employee retention: an empirical investigation of Pakistan’s health-care industry

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Attia Aman-Ullah ◽  
Azelin Aziz ◽  
Hadziroh Ibrahim ◽  
Waqas Mehmood ◽  
Yasir Abdullah Abbas
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Employee Retention ◽  
Health Care Industry ◽  
Job Security ◽  
Job Embeddedness ◽  
Public Hospitals ◽  
Content Type ◽  
Care Industry ◽  
The Impact

Purpose The purpose of this study is to determine the impact of job security on doctors’ retention, with job satisfaction and job embeddedness as the mediators. In doing so, the authors seek to contribute to the existing literature by providing additional empirical evidence on the links between job security, job satisfaction, job embeddedness and employee retention by using social exchange theory. Design/methodology/approach An empirical study was conducted on doctors working in public hospitals in Pakistan. Data from selected public hospitals were collected using semi-structured questionnaires. The simple random sampling method was applied for participant selection and partial least squares-structural equation modelling was used for data analysis purposes. Findings The findings confirmed the direct and mediation relationships. Thus, all of this study’s hypotheses are supported. The results indicate that job security can improve doctors’ retention. Further, job satisfaction and job embeddedness play crucial roles in mediating the direct relationship. Originality/value This study elaborates job security in health-care sector of Pakistan and also provides empirical evidence of the antecedents and mediators of doctors’ intention to continue working in the health-care industry.

scholarly journals Lean management in health care: a review of reviews of socio-technical components for effective impact

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marta Marsilio ◽  
Martina Pisarra
Keyword(s):  
Health Care ◽  
Implementation Process ◽  
Management Approach ◽  
Lean Management ◽  
Impact Measurement ◽  
Content Type ◽  
Four Dimensions ◽  
Support Organization ◽  
Review Of Reviews

PurposeThe aims of the implementation of lean management in health care are to improve quality of care, to eliminate waste and to increase efficiency. The purpose of this study is to contribute to the advancement of knowledge by investigating which main socio-technical factors are considered to be effective for the implementation and management of lean initiatives.Design/methodology/approachA systematic review of literature reviews on lean management in health care was conducted. The components of the socio-technical system are identified by moving from the socio-technical drivers that support organization-wide quality improvement practices and the lean implementation process in health care. The impacts of lean management are classified using the internal processes, patient, learning and financial dimensions.FindingsThe 28 reviews retrieved confirm the current and increasing interest in lean management. While more than 60% of them call for a system-wide approach, system-wide implementations have rarely been observed, and, instead, adoption in isolated units or departments, or the use of single techniques and tools, prevails. The most commonly investigated socio-technical components are organizational structure, techniques and tools and organizational culture and strategic management. Significant impacts are reported for all the four dimensions. Nonetheless, the review reveals that there is still a lack of evidence on the sustainability of lean results and a need for a standardized impact measurement system.Originality/valueThis work stands out as the first review of reviews of how the socio-technical components of the lean management approach obtain positive impacts within the patient, internal processes, learning and financial dimensions.

Public-private: unequal competition Israeli public hospitals vs the private health-care system following government reforms

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lior Naamati Schneider
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Data Gathering ◽  
State Regulation ◽  
Public Hospitals ◽  
Content Type ◽  
Creative Solutions ◽  
Government Reforms ◽  
Care System

Purpose This study aims to map perceptions and changes in public hospitals in response to competition with the private health system, describes solutions adopted by the public hospitals and considers their implications for the business and strategic management of those hospitals. Design/methodology/approach This paper opted for a qualitative study using the open-ended approach of grounded theory, including 40 in-depth interviews with key figures in the health system and administrators at various levels of management. Findings Public hospitals are constantly adopting changes because of state-mandated reforms and growing competition with private hospitals. Notable measures include making hospitals customer-oriented and adopting business-oriented behaviors and competitive and marketing strategies. However, because public hospitals are unable to institute radical changes, they typically introduce hybrid services (private services within public services) and other creative solutions such as business-funded research foundations operating alongside them. Research limitations/implications The main methodological limitation of this study was the difficulty in obtaining data because of the limited cooperation and lack of transparency of Israel’s health-care system. The interviewees expressed concerns that their department or hospital would appear in a negative light, especially as motivated solely by financial considerations. In anticipation of this difficulty, requests for participation were addressed individually and contained extensive detail regarding the study, the ethics committee’s approval, the data gathering and the strict maintenance of anonymity and confidentiality. Originality/value Adopting business-oriented behaviors in public hospitals is somewhat contrary to the principles of public medicine. Their adaptation to the market is partial, and their creative hybrid solutions require state regulation. The absence of controls leads to duplication and waste, causing various problems, including increased social inequality, costs and deficits.

Comparing and contrasting the evolution through time of organizational sustainability initiatives

2018 ◽  
Vol 10 (3) ◽  
pp. 296-315 ◽  
Author(s):  
Rocio Rodriguez ◽  
Göran Svensson ◽  
David Eriksson
Keyword(s):  
Health Care ◽  
Health Care Industry ◽  
Health Care Sector ◽  
Public Hospitals ◽  
Organizational Sustainability ◽  
Content Type ◽  
Care Industry ◽  
Private And Public ◽  
Sustainability Initiatives ◽  
Spanish Health

Purpose The purpose of this study is to compare private and public hospitals’ sustainability actions, as well as to contrast their organizational evolution over time (i.e. past, present and expected future) in the Spanish health-care sector. Sustainability initiatives refer to organizations’ economic, social and environmental actions. Design/methodology/approach This study applies an inductive approach based on judgmental sampling and in-depth interviews of key informants at private and public hospitals in the Spanish health-care sector. Data were gathered from the executive in charge of corporate social responsibility in public hospitals and the directors of communication at private hospitals. Findings Although the private and public hospitals studied are in the same health-care industry and run similar operations, their organizational sustainability initiatives in the past, present and expected future differ. The scope of sustainability initiatives between private and public hospitals is different, compared through time. Who was and who is promoting, as well as who is going to promote sustainability initiatives, also differs between private and public hospitals. Research limitations/implications One limitation of this study is that it was undertaken exclusively in Spanish organizations from one industry, but this is also a benefit, as it enables a comparison and contrast of the evolution between private and public hospitals. Future research could focus on the evolution of organizational sustainability initiatives in other industries and countries. Practical implications The reported comparison of empirical findings between private and public hospitals, as well as the subsequent discussion contrasting these findings, yields various managerial implications in terms of the scope and promotor of sustainable actions. Originality/value This study differs from previous ones by exploring the evolutionary details of the organizational sustainability initiatives through time in both private and public hospitals. This study also makes a contribution by revealing common denominators and differentiators between private and public hospitals that operate in the same health-care industry.

scholarly journals How prepared are Myanmar's health care professionals in their response to gender-based violence?

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Aye Nyein Ei ◽  
Montakarn Chuemchit
Keyword(s):  
Health Care ◽  
Environmental Factors ◽  
Care Management ◽  
Health Care Management ◽  
Public Hospitals ◽  
Health System Strengthening ◽  
Gender Based Violence ◽  
Content Type ◽  
Study Results ◽  
Gender Based

PurposeGender-based violence (GBV) has negative impact on the health and well-being of the survivors. The initial response can lessen the magnitude of the effect, and thus the health care sector's readiness to respond to GBV cases is important. This study aimed to explore the knowledge, attitude and its association to practice regarding GBV response among health care personnel.Design/methodology/approachA cross-sectional study was conducted in 48 public hospitals in Yangon, Myanmar, involving 398 participants including doctors and nurses, by a self-administered structured questionnaire.FindingsAmong 398 participants, most of the participants had moderate level of knowledge, attitude and supportive environmental factors. Only 12.8% had experienced GBV management. The respondents with a bachelor's degree were more likely to practice on health care management towards GBV cases than those who finished with a diploma degree. The medical officers and senior medical officers were more likely to practice than the junior nurses. The participants who had already attended the trainings had more practice than those who had not. Those who work in the regional hospitals were less likely to practice than those who work in the station-level hospital.Originality/valueThis paper explored the associated factors to health care personnel's practice of health care management towards GBV survivors in Myanmar which contains information about knowledge, attitude and supportive environmental factors. The study results can be used for a supportive data for health system strengthening the response of GBV cases in Myanmar.

The mediating role of the extensiveness of strategic planning on the relationship between slack resources and organizational performance

2015 ◽  
Vol 53 (5) ◽  
pp. 1023-1044 ◽  
Author(s):  
Yasir Fadol ◽  
Belal Barhem ◽  
Said Elbanna
Keyword(s):  
Health Care ◽  
Strategic Planning ◽  
Organizational Performance ◽  
Health Care Sector ◽  
Public Hospitals ◽  
Slack Resources ◽  
Content Type ◽  
Mediating Role ◽  
The Relationship

Purpose – The purpose of this paper is to improve the understanding of the mediating role of the extensiveness of strategic planning on the relationship between slack resources and organizational performance. Design/methodology/approach – The study uses empirical data gathered from 102 usable replies from private and also public hospitals in the United Arab Emirates (UAE). Findings – The findings indicate the existence of a positive relationship between slack resources and organizational performance and show that the extensiveness of strategic planning plays a mediating role in this relationship. Research limitations/implications – The authors highlight the exploratory nature of the study considering its unusual setting, namely, the UAE’s health care sector. Practical implications – Several implications of the findings for managerial and policy practices in the UAE health care sector are discussed. Originality/value – This study contributes to the existing literature on management, health care, and developing countries by examining the role of the extensiveness of strategic planning in mediating the relationship between slack resources and organizational performance in the health care industry of a developing country.

The mediation effects of finance on the relationship between service quality and performance of hospital facilities management services

Facilities ◽  
2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daniel Amos ◽  
Cheong Peng Au-Yong ◽  
Zairul Nisham Musa
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Service Quality ◽  
Public Hospitals ◽  
Facilities Management ◽  
Mediation Effects ◽  
Content Type ◽  
Services Delivery ◽  
And Performance ◽  
The Relationship

Purpose With rising health-care costs and the financial constraints in most developing countries, prioritization of needs have become an issue of strategic importance in public hospitals. As a result, there is the intense competition of scare resources between core health care and non-core facilities management (FM) services. Given that financial resources are needed to facilitate the smooth operation of the FM department, this paper aims to investigate the direct and indirect effects of finance on the relationship between service quality and performance of hospital FM services. Design/methodology/approach The paper adopts a quantitative approach following a general questionnaire survey which was conducted on the research population. Partial least squares structural equation modelling was used to investigate the relationships between service quality and performance of hospital FM services. Findings The study highlights the relevance of service quality to improving FM performance and demonstrate the direct and indirect influence of finance to ensure quality FM services delivery to improve core health care outcomes in hospitals. Practical implications The result of this study should motivate hospital management to prioritize attention on FM in scare resources management in public hospitals to create and maintain a decent health-care environment for better health outcomes. Further, managerial commitment to facilitate employee training, empowerment, incentives, awards and compensation should be strengthened in the quest of ensuring quality services delivery. Originality/value The paper extends knowledge by mediating the influence of finance on the relationship between service quality and FM performance. Proposes a parsimonious financial mediation framework which can easily be adaptable to several developing countries health-care FM management.

Key performance indicators for the maintenance of public hospitals buildings in the Gaza Strip

Facilities ◽  
2015 ◽  
Vol 33 (3/4) ◽  
pp. 206-228 ◽  
Author(s):  
Adnan Ali Enshassi ◽  
Farida El Shorafa
Keyword(s):  
Health Care ◽  
Performance Indicators ◽  
Public Hospital ◽  
Gaza Strip ◽  
Key Performance Indicators ◽  
Public Hospitals ◽  
Building Performance ◽  
Content Type ◽  
Care Situation ◽  
The Gaza Strip

Purpose – The purpose of this paper is to identify and assess the key performance indicators (KPIs) for the maintenance of public hospital buildings in the Gaza Strip. Design/methodology/approach – Four KPIs were identified and evaluated in this paper: building performance indicators (BPI), maintenance efficiency indicators (MEI), annual maintenance expenditure (AME) and urgent repair request indicator. Twenty-one buildings in 13 public hospitals in Gaza Strip Governorate were taken as the sample of this study. Findings – The results indicated that the European Gaza hospital has the highest BPI score (81.66) and the Dorra hospital has the lowest BPI score (68.26). The findings revealed that the average AME for all hospitals was $13.8/m2 which is considered to be below the standard level of expenditure. The MEI for Gaza public hospital buildings was found to be equal to 0.3 which indicated low level of maintenance expenditure. Research limitations/implications – Unavailability of certain data, lack of maintenance documentation and comparison difficulty between the Gaza Strip and Israel due to political, cultural and financial situation were some of the limitations of this study. Practical implications – The Ministry of Health (MoH) can utilize the results of this study and consider it as benchmarking for maintenance management in public hospital buildings. This can improve the current maintenance situation which ultimately will improve the health-care situation in Palestine. The Palestinian MoH should look for external funding to increase the AME, as well as aim at increasing the MEI. Social implications – The health-care situation in Palestine will be improved. Originality/value – This study is considered the first study to identify and assess the KPIs in the Gaza Strip. KPIs will assist the MoH to compare the actual and estimated performance in terms of effectiveness, efficiency and quality of workmanship.

The mediating role of job satisfaction in the relationship of vertical trust and distributed leadership in health care context

2016 ◽  
Vol 11 (2) ◽  
pp. 722-738 ◽  
Author(s):  
Ajay K. Jain
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Distributed Leadership ◽  
Positive Impact ◽  
Public Hospitals ◽  
Content Type ◽  
And Performance ◽  
The Impact ◽  
The Relationship

Purpose This study aims at investigating the effect of vertical trust on distributed leadership (DL) and performance as mediated by job satisfaction, and further to observe the role of DL in carrying out the effect of satisfaction on employees’ performance. Design/methodology/approach As grounded in the organizational citizenship behavior (OCB) literature, the author proposes that employees’ participation in DL should be viewed as an extra role behavior, as leadership functions are not directly related to their job description. The study uses large-scale survey data from a study in one of Denmark’s largest public hospitals (N = 1,439). Findings The results of structural equation modelling (SEM) analysis showed that job satisfaction mediates the relationship between vertical trust and DL, and DL had a positive impact on job performance. Furthermore, the results showed that job satisfaction had a positive impact on DL and employees’ performance. Moreover, DL has positively affected employees’ performance, and it carries the impact of job satisfaction on performance. Research limitations/implications The study showed that trust and job satisfaction are important triggers of DL. Furthermore, results are interesting because literature so far has shown an insignificant relationship between satisfaction and performance. Here, the author establishes that the satisfaction–performance relationship is mediated by DL. The findings should motivate health care organizations to introduce structures and educate formal leaders so that DL can be enabled. Originality/value This should be the first study that relates trust and DL in an empirical manner. As grounded in the OCB literature, results also showed the significance of job satisfaction as a mediator variable.

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