Health Services Management Research最新文献

{"title":"An exploration of factors leading to readiness for organizational health literacy change in community-based health organizations.","authors":"Melanie Stone, Ricardo Wray, Jason Rosenfeld, Melissa Valerio-Shewmaker, Teresa Wagner","doi":"10.1177/09514848241295655","DOIUrl":"10.1177/09514848241295655","url":null,"abstract":"<p><p>IntroductionHealthcare systems have a responsibility to improve organizational health literacy (OHL) to increase health equity. This study explored two organizational cultural factors, leadership support and staff buy-in, for organizations planning OHL change.MethodsTen community-based health organizations participated in an OHL program. The study design was mixed methods. The qualitative inquiry was interviews with senior leaders to explore awareness of OHL and: impetus to transform, leadership commitment, staff engagement, alignment to organizational goals, and integration of health literacy change with current practices. The quantitative assessment was the Organizational Readiness for Implementing Change (ORIC) questionnaire to assess staff's perceptions about OHL change readiness.ResultsSenior leaders articulated the effects of low health literacy in their patient and client population. Support for OHL change was seen at both leadership and staff levels. Impetus for change was primarily a response to a community need or for quality improvement. Most of the non-clinical organizations had higher ORIC scores than the clinical organizations, indicating a perceived higher level of readiness for OHL change.ConclusionLeadership commitment and staff buy-in are important factors of readiness for OHL change. A novel finding is that community-based health organizations are able and willing to engage in OHL change.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"146-153"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Is IT really good for all?\" Evidence of different stakeholders' perspectives on the digital transformation of hospitals in the French health context.","authors":"Antonio Giangreco, Marion Lauwers, Andrea Martone, Francine Ponchaux","doi":"10.1177/09514848251332566","DOIUrl":"10.1177/09514848251332566","url":null,"abstract":"<p><p>Over the last two decades, processes of digital transformation have been progressively implemented in the sphere of public services, including the health sector, albeit at difference paces depending on organizations' levels of digital maturity. Although the nominal advantages of digitalizing health services are well identified in the conception phase, once implemented, the perceptions of different stakeholders tend to differentiate, even generating certain tensions. Based on qualitative grounded theory research approach among 15 different stakeholders from nine different hospitals of a regional health system located in the northern part of France, this study shows that different stakeholders perceived different advantages, such as improving the integration between the different stakeholders' practices, improving care practices, offering more services, and reducing costs and increasing efficiency. However, a paradox also emerged in the contraposition between the need for higher perceived quality, which requires more investments, and the search for efficiency through the digital transformation of health services, which aims at reducing costs. We conclude by discussing the theoretical contributions and implications for practice.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"173-183"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emergence and organizational choices of patient advocacy associations: Evidence from the Italian context.","authors":"Federica Morandi, Eugenio Di Brino, Americo Cicchetti","doi":"10.1177/09514848241263728","DOIUrl":"10.1177/09514848241263728","url":null,"abstract":"<p><p>BackgroundWithin many advanced healthcare systems, patient advocacy associations are gaining a more relevant role in healthcare policy decisions. These associations provide help, representation, and voice to patients and citizens. However, although their role is important, a paucity of research exists analyzing their foundation dynamics, including their organizational decision, from a managerial perspective. To fill this knowledge gap, we formulated two research questions to investigate the motivations underlying the foundation of patient advocacy associations and the institutional pressures influencing the changes that have occurred in these associations throughout their evolution.MethodsUsing a semi-structured questionnaire developed as part of a larger research project, we collected data about 31 patient advocacy associations operating within the Italian National Health Service. We employed qualitative analysis to examine the associations' birth and evolution as well as the motivations and influences driving change within the sampled organizations.ResultsQuestionnaire responses provided information about the patient advocacy associations' histories and highlighted their close links with the Italian National Health Service. Our results indicated the motivations for the associations' establishment could be grouped into five categories: support at the system level, patient protection and support, actions to increase awareness, actions for improving patients' health and quality of life, and dissemination of knowledge. We also identified the frequency and nature of the changes within the associations and explored the institutional pressures that influenced these organizational changes.ConclusionsThe results can be interpreted considering the organizational theories that focus on organizations' establishment decisions and how external pressures impact organizations' dynamics and evolution.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"128-134"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of hospital resilience as the main challenge of hospital management during the COVID-19 pandemic: A grounded theory study.","authors":"Sulmaz Ghahramani, Kamran Bagheri Lankarani, Mohammadreza Zakeri, Sahar Ghahramani, Payam Shojaei","doi":"10.1177/09514848241309285","DOIUrl":"10.1177/09514848241309285","url":null,"abstract":"<p><p>BackgroundTraditional hospital management responses during the coronavirus disease 2019 (COVID-19) pandemic proved ineffective, particularly considering the pre-existing challenges in healthcare systems. The study examines hospital management challenges during the COVID-19 pandemic, transforming their lived experiences into a conceptual approach to prevent repetition and benefit health planners and policymakers in future crises and normal times.MethodsThis qualitative study utilized the grounded theory methodology, conducting in-depth interviews with 12 hospital administrators from seven major referral hospitals in Shiraz, Bushehr, and Tehran, focusing on COVID-19 patients' complex conditions. The participants had a mean age of 46.6 ± 8.8 years. Data analysis was conducted using the grounded theory (Straussian approach).ResultsA total of 98 subthemes and 25 themes were identified during the data analysis process. Using axial and selective coding, we found that in the presence of contextual and causal conditions, the lack of hospital resilience was recognized as the core theme in the final model. Intervening conditions, strategies to overcome the challenges of hospital management, and the outcomes were identified.ConclusionsIranian hospital administrators dealing with COVID-19 recognize the lack of hospital resilience as their main management obstacle. Non-resilient hospitals' response to crises with new management strategies can fail due to insufficient documentation and information sharing, leading to persistent problems. Prioritizing evidence-based strategies and sharing successful approaches from other healthcare systems can improve resilience. Nationwide guidelines will ensure equitable patient treatment and reduce lawsuits against physicians for resource-efficient use. Hospital resilience implementation in real-world settings is widely sought for evidence.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"164-172"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of policy and technology infrastructure on telehealth utilization.","authors":"Ying-Chih Sun, Ozlem Cosgun, Raj Sharman","doi":"10.1177/09514848241276471","DOIUrl":"10.1177/09514848241276471","url":null,"abstract":"<p><p>The COVID-19 outbreak resulted in an unprecedented surge in telehealth utilization. However, the effects of policy enactment on utilization remain understudied in the literature. Our research examines the impact of policy mandates relating to federal incentive programs on telehealth utilization across states during the pandemic by considering technology infrastructure, such as broadband penetration and equipment possession. This study also considers the impact of political orientation and control factors, including income attributes, on telehealth utilization. Considering telehealth utilization in the Medicare program as a test case, this study employed the partial least square and structural equation model to analyze data from the Centers for Medicare & Medicaid Services, the American Community Survey, and the Microsoft Airband Project to draw inferences. Our study finds that telehealth legislation, broadband penetration, political orientation, and control factors have a direct significant impact on telehealth utilization, whereas incentive programs and equipment possession have an indirect impact through broadband penetration.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"135-145"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of care discontinuity in chronic outpatient care: A mixed method case study.","authors":"Anu Vehkamäki, Märt Vesinurm, Riina-Riitta Helminen, Olli Halminen, Paul Lillrank","doi":"10.1177/09514848241307183","DOIUrl":"10.1177/09514848241307183","url":null,"abstract":"<p><p>BackgroundWhile health systems are primarily designed for acute health issues, managing life-long conditions often results in chronic care discontinuity. This refers to situations where a chronic patient's planned care fails to actualise.Research DesignThis study descriptively explores the reasons behind chronic care discontinuity in outpatient care.Data CollectionData was collected via interviews and a focus group with healthcare professionals, and a patient survey specifically targeting chronic abdominal patients.AnalysisUsing grounded theorising the Discontinuity of Chronic Care (DoCC) framework was developed, to identify and categorise reasons behind chronic care discontinuity.ResultsThe framework reveals that reasons for discontinuity can be largely divided into healthcare system related factors-including caregiver, technological, and process challenges-and patient-related factors such as situational and internal psychological challenges.ConclusionsThe DoCC-framework provides a valuable tool for analysing various patient processes, offering healthcare managers insights to improve the management of chronic patient journeys. Additionally, it guides healthcare professionals to better focus their development efforts on challenges they have the capacity to address.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"154-163"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future is now.","authors":"Federico Lega","doi":"10.1177/09514848251341393","DOIUrl":"10.1177/09514848251341393","url":null,"abstract":"","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"127"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of warmth and competence as stereotypical leadership perceptions on occupational well-being and behavioral loyalty of hospital employees: An empirical analysis.","authors":"Marcella S Mueller, Chris Malone, Jörg Lindenmeier, Zeynep Erden, Florian Liberatore","doi":"10.1177/09514848251360072","DOIUrl":"https://doi.org/10.1177/09514848251360072","url":null,"abstract":"<p><p><b>Background:</b> The shortage of healthcare professionals and demanding working conditions have prompted healthcare organizations to implement effective retention strategies. Leadership practices largely shape the organizational climate and influence occupational well-being and related retention. Research has identified warmth and competence as the two fundamental dimensions by which leaders are evaluated.<b>Purpose:</b> This study explores how perceptions of leadership-related warmth and competence translate into hospital employees' loyalty, both directly and indirectly, through occupational well-being, that is, through the mechanisms of positive and negative work-related affect.<b>Research Design:</b> A cross-sectional survey design was used.<b>Study Sample:</b> The study sample consisted of N = 1907 employees from a U.S. hospital.<b>Data Collection and Analysis:</b> Data were collected via a structured survey instrument assessing leadership perceptions, affective well-being at work, and employee loyalty. Structural equation modeling was used to assess the hypothesized relationships and mediating mechanisms.<b>Results:</b> Both leadership-related warmth and competence perceptions directly influence employee loyalty. We identified different mechanisms underlying the indirect effects of occupational well-being on loyalty. Only leadership-related warmth perceptions had a positive indirect effect on loyalty through both positive and negative work-related affect. Leadership-related competence perceptions increased both positive and negative work-related affect.<b>Conclusions:</b> An empathic leadership style that leads to favorable leadership-related warmth perceptions is an effective approach for promoting occupational well-being and loyalty among hospital employees. Leaders should foster leadership-related competence perceptions in periods with more favorable working conditions while avoiding them in stressful working conditions.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251360072"},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance of a patient portal: Analysis of an Italian regional public system.","authors":"Alberto Zanutto, Diego Ponte, Diego Giuliani, Maria Michela Dickson","doi":"10.1177/09514848251358321","DOIUrl":"https://doi.org/10.1177/09514848251358321","url":null,"abstract":"<p><p>BackgroundPatient portals allow patients to access their health information and interact with their healthcare system. While their use is still limited, this article explores the behavioral intention to use a patient portal implemented by a public regional authority in Italy. The authors also investigate the role of sociodemographic moderators - age, gender, education, and occupation - on the intention to use the portal.MethodsWhile most of the literature on patient portals is focused on small sets of respondents or is verticalized on specific diseases, this paper describes the results of a survey sent to 34,256 users registered on the patient portal. Of these, 15,102 users answered the questionnaire. The survey explored the acceptance of the patient portal through the extended unified theory of acceptance and use of technology model (UTAUT2). Descriptive and SEM analyses were also conducted.ResultsThe model has good explanatory power for the behavioral intention to use a patient portal. One construct of the UTAUT2 model showed insignificant effects on the intention to use. The results indicate that the impact of the constructs affecting the intention to use the patient portal is significantly moderated by individuals' sociodemographic characteristics.ConclusionsThe analysis results confirm a good acceptance of patient portals provided by public authorities. This supports the idea that public institutions can also develop innovative tools. The results confirm the desirability of these tools among citizens. The results have important policy implications for public health investments.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251358321"},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining knowledge-generation-driven blockchain for healthcare use: Insights from medical institutions.","authors":"Amir A Abdulmuhsin, Abdulkareem H Dbesan, Shafique Ur Rehman, Alhamzah Alnoor, Abeer F Alkhwaldi","doi":"10.1177/09514848251358332","DOIUrl":"https://doi.org/10.1177/09514848251358332","url":null,"abstract":"<p><p>This study explores the factors influencing healthcare professionals' willingness to adopt knowledge-generation-driven Blockchain technology (KGDBT) in government healthcare facilities, using the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) framework. It introduces transparency as an independent variable and examines the mediating role of knowledge generation in the relationship between transparency and healthcare professionals' intention to adopt KGDBT. Data were collected from 322 healthcare professionals in government hospitals and analyzed using SPSS version 26 and SmartPLS version 3.9 for Partial Least Squares Structural Equation Modeling (PLS-SEM). The results strongly support the theoretical framework, demonstrating that performance expectancy, effort expectancy, social influence, facilitating conditions, and transparency significantly influence healthcare professionals' adoption of Blockchain technology. Additionally, the study identifies knowledge generation as a critical mediating factor between transparency and behavioral intention to adopt KGDBT. This research addresses the challenges of implementing Blockchain technology in healthcare by proposing a knowledge management-oriented approach to enhance its effectiveness. It highlights the critical role of transparency in promoting technology adoption and fills a gap in the literature on Blockchain and knowledge management, particularly within the Iraqi healthcare context. This study offers new insights, contributing to a comprehensive understanding of the role of knowledge generation in Blockchain adoption.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251358332"},"PeriodicalIF":1.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}