Health Services Management Research最新文献_第10页

Why are there so many hospital beds in Germany? 为什么德国有这么多医院床位?

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221080691

Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl

{"title":"Why are there so many hospital beds in Germany?","authors":"Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl","doi":"10.1177/09514848221080691","DOIUrl":"https://doi.org/10.1177/09514848221080691","url":null,"abstract":"The place of hospitals in health systems is undergoing rapid change worldwide due to the high cost of hospital care and the changing health needs of the population. The Covid-19 pandemic has recently drawn public attention towards hospital capacity and has added new urgency to discussions on the future role of hospitals. In this context, recent experience in Germany provides valuable information for health systems seeking to manage hospital capacity. Despite reform efforts to reduce hospital capacity, Germany has the highest rates of intensive care beds among high-income countries and the highest overall hospital capacity in Europe. The capacity of the German hospital system can be explained in large part by the high number of elderly in-patients. This, in turn, is driven by (1) a fragmented ambulatory care system; (2) physicians admitting and maintaining elderly patients in hospital at a high rate; (3) a hospital market adding incentives to admit patients; and (4) a political commitment to egalitarian access and universal care. Additionally, recent policies to reduce hospital capacity have had limited impact because hospitals have not responded to financial incentives in the expected manner. Countries looking to learn from Germany's hospital capacity must therefore consider systemic features, political commitments, and unintended policy consequences.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"75-81"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9134865","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}

引用次数: 2

COVID-19 management at one of the largest hospitals in Germany: Concept, evaluation and adaptation. 德国最大医院之一的COVID-19管理:概念、评估和适应。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221100752

Ana Zhelyazkova, Philipp M Fischer, Nina Thies, Julia S Schrader-Reichling, Thorsten Kohlmann, Kristina Adorjan, René Huith, Karl-Walter Jauch, Stephan M Prückner

{"title":"COVID-19 management at one of the largest hospitals in Germany: Concept, evaluation and adaptation.","authors":"Ana Zhelyazkova, Philipp M Fischer, Nina Thies, Julia S Schrader-Reichling, Thorsten Kohlmann, Kristina Adorjan, René Huith, Karl-Walter Jauch, Stephan M Prückner","doi":"10.1177/09514848221100752","DOIUrl":"https://doi.org/10.1177/09514848221100752","url":null,"abstract":"Context: The LMU University Hospital is among the largest healthcare facilities in Germany. The measures implemented prior to and during the first pandemic wave of COVID-19, were evaluated in preparation of a second pandemic wave. This paper presents the pandemic management concept, evaluation and adaptation of LMU University Hospital.Methods: Between July and September 2020 the disaster management team of LMU University Hospital conducted a mixed-method evaluation of the hospital's pandemic management. A workshop series based on the After Action Review working group format was organized to examine the management structure, decision-making processes, documentation, and crisis preparedness response for a second COVID-19 wave. Further, the satisfaction of employees with the hospital's COVID-19 management was examined through an anonymous survey.Results: The workshop series highlighted a need for structural and operational adaptation of the COVID-19 management at LMU University Hospital. The results of the employee survey (N = 2182) provided positive feedback for the measures taken during the first pandemic wave. Specific actions were derived concerning the availability of personal protective equipment and emergency childcare services. A key outcome of both evaluation activities was the identified need for further improvement in communication between stakeholders. All changes were adopted prior to the second pandemic wave.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"63-74"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9117989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-effectiveness of future lockdown policies against the COVID-19 pandemic. 未来针对COVID-19大流行的封锁政策的成本效益。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221080687

Afschin Gandjour

{"title":"Cost-effectiveness of future lockdown policies against the COVID-19 pandemic.","authors":"Afschin Gandjour","doi":"10.1177/09514848221080687","DOIUrl":"https://doi.org/10.1177/09514848221080687","url":null,"abstract":"Aim: While the European Union (EU) has approved several COVID-19 vaccines, new variants of concern may be able to escape immunity. The purpose of this study is to project the cost-effectiveness of future lockdown policies in conjunction with a variant-adapted vaccine booster. The exemplary scenario foresees a 25% decline in the vaccine protection against severe disease.Methods: A decision model was constructed using, for example, information on age-specific fatality rates, intensive care unit (ICU) costs and outcomes, and herd protection threshold. The costs and benefits of a future lockdown strategy were determined from a societal viewpoint under three future scenarios-a booster shot's efficacy of 0%, 50%, and 95%.Results: The cost-effectiveness ratio of a lockdown policy in conjunction with a booster dose with 95% efficacy is €44,214 per life year gained. A lockdown is cost-effective when the probability of approving a booster dose with 95% efficacy is at least 48% (76% when considering uncertainty in input factors).Conclusion: In this exemplary scenario, a future lockdown policy appears to be cost-effective if the probability of approving a variant-adapted vaccine booster with an efficacy of 95% is at least 48%.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"51-62"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984600/pdf/10.1177_09514848221080687.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9164394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Competitive intelligence: A precursor to a learning health system. 竞争情报:学习健康系统的先兆。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848211065470

H Fred Farley, Shelly Freyn

{"title":"Competitive intelligence: A precursor to a learning health system.","authors":"H Fred Farley, Shelly Freyn","doi":"10.1177/09514848211065470","DOIUrl":"https://doi.org/10.1177/09514848211065470","url":null,"abstract":"Unlike other developed countries, the US healthcare system is largely privatized and highly competitive. This dynamic stifles effective information sharing, while the need for prompt and accurate evidence-based decision making has become crucial. Crises, like the COVID-19 pandemic, elevate the importance of quality decision making and exacerbate issues associated with the lack of a cohesive system to share information. Competitive intelligence (CI) is a discipline that encourages gathering, analyzing, and sharing information throughout a firm in order to develop and sustain competitive advantage. CI could be considered a precursor in establishing a learning organization (LO). Although CI research has focused on its process and value, little is found in the literature on how to integrate CI into an organization; this is particularly true in healthcare. A conceptual model is proposed to build and integrate a CI function and culture within a healthcare organization to encourage effective information sharing and knowledge development. In turn, this can provide a mechanism to create a learning health system (LHS). Although the model was developed specifically for US healthcare, it offers application to healthcare in other countries as well as most any industry.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"82-88"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9134844","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}

引用次数: 0

Association between asthma control and healthcare costs: Results from a German linked data study. 哮喘控制与医疗费用之间的关系:来自德国相关数据研究的结果。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221100749

Thomas Wilke, Hartmut Timmermann, Sabrina Mueller, Fraence Hardtstock, Victoria Unmuessig, Robert R Welte, Ulf Maywald

{"title":"Association between asthma control and healthcare costs: Results from a German linked data study.","authors":"Thomas Wilke, Hartmut Timmermann, Sabrina Mueller, Fraence Hardtstock, Victoria Unmuessig, Robert R Welte, Ulf Maywald","doi":"10.1177/09514848221100749","DOIUrl":"https://doi.org/10.1177/09514848221100749","url":null,"abstract":"Background: This study aimed to evaluate differences in healthcare resource utilization and cost among patients with controlled and uncontrolled asthma.Methods: Claims data from a German sickness fund was linked to patient survey data. Outpatient physicians enrolled patients and assessed asthma control using the ACTTM questionnaire. All-cause and asthma-specific healthcare resource use (HCRU)/costs were compared descriptively and based on multivariable models using a continuous ACTTM score.Results: Overall, 492 asthma patients were included (mean age: 53.8, 73.8% female). The mean/median ACTTM score was 19.9/20.7, with 183 patients (37.2%) classified as having uncontrolled asthma (mean ACTTM score<20) Patients with uncontrolled asthma had significantly more hospitalizations (p = .035) and medication prescriptions (p < .001), which resulted in higher total healthcare costs for asthma-related (€1785 vs. €1615; p = .004) and all-cause care (€4695 vs. €4117; p = .009). While controlling for baseline characteristics, multivariable models confirmed a negative association between asthma control and total all-cause healthcare costs (p = .008), total asthma-related costs (p = .008), and costs of medication prescriptions (p = .001). However, no significant association was found for all-cause (p = .062) and asthma-related hospitalization costs (p = .576).Conclusion: Considering continuous patient care, improving asthma control is not only desirable from a clinical perspective, but could also be an effective approach to reduce asthma-related HCRU and cost burden.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"42-50"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9135356","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}

引用次数: 0

Responsible innovation in health and health system sustainability: Insights from health innovators' views and practices. 负责任的卫生创新和卫生系统可持续性:来自卫生创新者的观点和实践的见解。

IF 2.1

Health Services Management Research Pub Date : 2022-11-01 DOI: 10.1177/09514848211048606

Pascale Lehoux, Hudson P Silva, Robson Rocha de Oliveira, Renata P Sabio, Kathy Malas

{"title":"Responsible innovation in health and health system sustainability: Insights from health innovators' views and practices.","authors":"Pascale Lehoux, Hudson P Silva, Robson Rocha de Oliveira, Renata P Sabio, Kathy Malas","doi":"10.1177/09514848211048606","DOIUrl":"https://doi.org/10.1177/09514848211048606","url":null,"abstract":"Although healthcare managers make increasingly difficult decisions about health innovations, the way they may interact with innovators to foster health system sustainability remains underexplored. Drawing on the Responsible Innovation in Health (RIH) framework, this paper analyses interviews (n=37) with Canadian and Brazilian innovators to identify: how they operationalize inclusive design processes; what influences the responsiveness of their innovation to system-level challenges; and how they consider the level and intensity of care required by their innovation. Our qualitative findings indicate that innovators seek to: 1) engage stakeholders at an early ideation stage through context-specific methods combining both formal and informal strategies; 2) address specific system-level benefits but often struggle with the positioning of their solution within the health system; and 3) mitigate staff shortages in specialized care, increase general practitioners' capacity or patients and informal caregivers' autonomy. These findings provide empirical insights on how healthcare managers can promote and organize collaborative processes that harness innovation towards more sustainable health systems. By adopting a RIH-oriented managerial role, they can set in place more inclusive design processes, articulate key system-level challenges, and help innovators adjust the level and intensity of care required by their innovation.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"35 4","pages":"196-205"},"PeriodicalIF":2.1,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/60/10.1177_09514848211048606.PMC9574029.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10408202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Managers do it their way: How managers act in a decentralised healthcare services provider organisation - a mixed methods study. 管理者按自己的方式做事:管理者如何在分散的医疗服务提供商组织中行动——一项混合方法研究。

IF 2.1

Health Services Management Research Pub Date : 2022-11-01 DOI: 10.1177/09514848211065467

Mikael Ohrling, Sara Tolf, Karin Solberg-Carlsson, Mats Brommels

{"title":"Managers do it their way: How managers act in a decentralised healthcare services provider organisation - a mixed methods study.","authors":"Mikael Ohrling, Sara Tolf, Karin Solberg-Carlsson, Mats Brommels","doi":"10.1177/09514848211065467","DOIUrl":"https://doi.org/10.1177/09514848211065467","url":null,"abstract":"Purpose: Decentralisation is considered a way to get managers more committed and more prone to respond to local needs. This study analyses how managers perceive a decentralised management model within a large public healthcare delivery organisation in Sweden. Design/methodology/approach: A programme theory evaluation was performed applying direct content analysis to in-depth interviews with healthcare managers. Balance score card data were used in a blinded comparative content analysis to explore relations between performance and how the delegated authority was perceived and used by the managers. Findings: Managers' perceptions of the decentralised management model supported its intentions to enable the front-line to make decisions to better meet customer needs and flexibly adapt to local conditions. The managers appreciated and used their delegated authority. Central policies and control on human resources and investments were accepted as those are to the benefit of the whole organisation. Leadership development and organisation-wide improvement programmes were of support. Units showing high organisational performance had proactive managers, although differences in manager perceptions across units were small. Originality: This, one of the first of its kind, study of a decentralisation in service delivery organisation shows a congruence between the rationale of a management model, the managers' perceptions of the authority and accountability as well as management practises. These observations stemming from a large public primary and community healthcare organisation has not, to our knowledge, been reported and provide research-informed guidance on decentralisation as one strategy for resolving challenges in healthcare service delivery organisations.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"35 4","pages":"215-228"},"PeriodicalIF":2.1,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406966","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}

引用次数: 3

After all we're only human. 毕竟我们只是人。

IF 2.1

Health Services Management Research Pub Date : 2022-11-01 Epub Date: 2022-10-06 DOI: 10.1177/09514848221133242

Federico Lega

引用次数: 0

A qualitative study on relationships and perceptions between managers and clinicians and its effect on value-based healthcare within the national health service in the UK. 对关系和管理者和临床医生之间的看法及其对英国国家卫生服务中基于价值的医疗保健的影响的定性研究。

IF 2.1

Health Services Management Research Pub Date : 2022-11-01 Epub Date: 2022-02-08 DOI: 10.1177/09514848211068624

Sze May Ng

{"title":"A qualitative study on relationships and perceptions between managers and clinicians and its effect on value-based healthcare within the national health service in the UK.","authors":"Sze May Ng","doi":"10.1177/09514848211068624","DOIUrl":"https://doi.org/10.1177/09514848211068624","url":null,"abstract":"One of the main drivers for change towards delivering value-based healthcare is to improve clinical and managerial culture and engagement within organisations. The relationships between clinicians and managers in an organisation are often considered to be either an enabler or disabler towards successful engagement to develop strategies towards better value healthcare. Successful engagement is dependent on effective and transformational leadership that can impact on organisational value in healthcare. The aim of this research was to explore the relationships, behaviours and perceptions between managers and clinicians towards value-based healthcare in the National Health Service in the United Kingdom. A qualitative research methodology of semi-structured in-depth interviewing on a sample consisting of hospital consultants, senior managers and board executives from a diverse group were conducted. A thematic analysis was used to analyse the data using a systematic approach. The study findings identified areas of potential barriers to engagement for clinicians and managers which were related to regulatory burden, financial challenges and workforce shortages. Key recommendations on what will be required to improve clinicians and managers engagement and the leadership approaches towards improving value-based healthcare are discussed.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"251-258"},"PeriodicalIF":2.1,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39762932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Examining supervisor undermining through the job-demands resources framework. 通过工作需求资源框架考察主管破坏行为。

IF 2.1

Health Services Management Research Pub Date : 2022-11-01 DOI: 10.1177/09514848211048608

Marilyn V Whitman, Russell A Matthews, Eric S Williams

{"title":"Examining supervisor undermining through the job-demands resources framework.","authors":"Marilyn V Whitman, Russell A Matthews, Eric S Williams","doi":"10.1177/09514848211048608","DOIUrl":"https://doi.org/10.1177/09514848211048608","url":null,"abstract":"Introduction: Supervisor undermining has recently gained increasing attention due to its negative effects on employee health and well-being. In the healthcare context, negative supervisor behaviors have been linked to unfavorable individual and organizational outcomes as well as medical errors and patient mortality. Our study, therefore, examines the influence that supervisor undermining behavior has on employee engagement and performance within a standard job stress framework.Methods: Our sample consisted of occupational therapists, a health professions group who is growing in demand and importance in the U.S. and has unique job demands. Using an observational, cross-sectional study design, a convenience sample of 521 occupational therapists completed an online survey. A series of independent t-test and multiple-groups path analytic modeling was used.Results: Participants who had a supervisor perceived as engaging in undermining behaviors reported lower levels of resources, higher levels of demands, less motivation, and more overload than those who did not perceive supervisor undermining. These participants were also less engaged and reported lower levels of performance.Conclusion: Our results shed further light on the importance of supervisory behaviors specifically in a healthcare setting and the need for organizations to create an environment that promotes positive and productive workplace behaviors.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"35 4","pages":"206-214"},"PeriodicalIF":2.1,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406487","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}

引用次数: 1