Health Services Management Research最新文献_第4页

A comparative evaluation of organizational models of physiotherapy through measures reported by patients. 通过患者报告的措施对物理治疗的组织模式进行比较评价。

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Health Services Management Research Pub Date : 2025-12-13 DOI: 10.1177/09514848251393487

Alessandra Da Ros, Francesca Pennucci, Giaele Moretti, Sabina De Rosis

{"title":"A comparative evaluation of organizational models of physiotherapy through measures reported by patients.","authors":"Alessandra Da Ros, Francesca Pennucci, Giaele Moretti, Sabina De Rosis","doi":"10.1177/09514848251393487","DOIUrl":"https://doi.org/10.1177/09514848251393487","url":null,"abstract":"Background: Identifying the value and quality of organisational models supports the performance of the overall healthcare system and the effectiveness of its processes.Purpose: Based on an organizational case of physiotherapy care delivery, this study compares a traditional organizational model with the most recent fast-track approach within the total hip replacement (THR) surgery pathway.Research Design: Through a Propensity Score Matching (PSM) application, the study aims to analysing the impact of two different models on patient-reported outcomes.Study Sample: Patient-Reported Outcome Measures (PROMs) data collected between 2018 and 2023 through the PROMs Observatory in the Tuscany region (Italy) were used.Results: The results, based on 417 responses, suggest that the two organizational models produce equivalent outcomes reported by patients' voices at different timepoints, while the models have different organizational characteristics that result in increased allocative value in terms of shorter length of stay (LOS) and associated reduced resource use.Conclusions: From a Lean Management perspective, the managers' decision-making process is supported by evidence on the adoption of the most valuable organizational model using both clinical and organizational data from the patient's point of view.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251393487"},"PeriodicalIF":0.7,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744655","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

Health workforce planning in the era of proximity healthcare: A systematic literature review. 近距离医疗时代的卫生人力资源规划：系统的文献综述。

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Health Services Management Research Pub Date : 2025-12-09 DOI: 10.1177/09514848251398797

Irene Gabutti, Daniele Pandolfi, Luigi Apuzzo, Lorena Martini

{"title":"Health workforce planning in the era of proximity healthcare: A systematic literature review.","authors":"Irene Gabutti, Daniele Pandolfi, Luigi Apuzzo, Lorena Martini","doi":"10.1177/09514848251398797","DOIUrl":"https://doi.org/10.1177/09514848251398797","url":null,"abstract":"BackgroundGeneral system's theory posits that changing one part of a system will affect other parts of it. Healthcare systems are facing deep changes, but health workforce (HWF) planning methods are not necessarily evolving accordingly. In practical terms, this means that guaranteeing the presence of key professionals able to translate strategies of change into concrete new and effective models of care is problematic.PurposeTo assess whether scholars and managers are indeed tackling key trends of change in healthcare systems when designing and adopting HWF planning tools.MethodsA systematic literature review carried out according to the PRISMA methodology.Results21 articles were included in the final revision. Emerging themes include HWF planning approaches and methods, issues concerning data availability and management of professionals' competencies. Recurrent contents suggest that HWF approaches are not completely anchored to the main trends of change of healthcare systems.Practice implicationsHWF strategies should follow the demand-, supply-, need-taxonomy and should shift from a \"professional-centric\" to a \"job-centric\" approach.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251398797"},"PeriodicalIF":0.7,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710264","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

Understanding research capacity and culture of Allied Health clinicians working within a metropolitan tertiary hospital. 了解在大城市三级医院工作的联合健康临床医生的研究能力和文化。

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Health Services Management Research Pub Date : 2025-11-05 DOI: 10.1177/09514848251384284

Michelle Cottrell, Sara Winter

{"title":"Understanding research capacity and culture of Allied Health clinicians working within a metropolitan tertiary hospital.","authors":"Michelle Cottrell, Sara Winter","doi":"10.1177/09514848251384284","DOIUrl":"https://doi.org/10.1177/09514848251384284","url":null,"abstract":"BackgroundClinician engagement in research is shaped by research capacity building and organizational culture. This study aimed to assess current capacity and culture, and understand factors influencing research engagement.MethodsA sequential explanatory mixed-methods design was used, involving a Research Capacity and Culture (RCC) survey followed by interviews and focus groups at a major metropolitan tertiary hospital. All Health Practitioner and Clinical Assistant staff were invited to participate. Survey data were analysed descriptively, and qualitative data from interviews/focus groups were analysed using Framework Analysis, incorporating the Theoretical Domains Framework. Suggested strategies were mapped to the Theory and Techniques Tool.ResultsSurveys were completed by 105 staff (37.3% response rate), and 23 participated in interviews/focus groups. Survey results showed high skills/success in organizational and team domains, but lower skills in individual domains. Qualitative findings revealed three main themes: (i) individual clinicians, (ii) organizational structure and culture, and (iii) access to support structures. Recommended strategies focused on social supports, incentives, and improving access to knowledge while reducing cognitive load.ConclusionsWhile clinicians recognise research as part of their role, challenges limit engagement. Prioritising practical support (e.g., offline time, clear communication) and developing organizational policies can foster sustained research engagement.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251384284"},"PeriodicalIF":0.7,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453727","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

How process-driven organizational change reshapes advice and expertise networks in hospitals. 流程驱动的组织变革如何重塑医院的咨询和专业知识网络。

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Health Services Management Research Pub Date : 2025-11-05 DOI: 10.1177/09514848251393489

Luca Giorgio, Mario Masiello, Giovanna Liuzzo

{"title":"How process-driven organizational change reshapes advice and expertise networks in hospitals.","authors":"Luca Giorgio, Mario Masiello, Giovanna Liuzzo","doi":"10.1177/09514848251393489","DOIUrl":"10.1177/09514848251393489","url":null,"abstract":"This study explores the dynamics of multiple social networks among healthcare professionals during a process-based reorganization in a hospital department, specifically examining how these relationships influence collaboration and adaptability amidst change. Utilizing a social network analysis framework, we investigate the interplay between advice and subject matter expertise (SME) networks among 67 healthcare professionals in a major Italian hospital. The findings reveal that the presence of multiplex ties-relationships characterized by various forms of interaction-facilitates enhanced collaboration and knowledge sharing, thereby improving the efficacy of organizational change initiatives. Notably, differing intentions regarding change among healthcare professionals can hinder the formation of new ties, indicating the importance of alignment in perceptions for successful network evolution. Ultimately, this study provides valuable insights into the transformative role of social networks in healthcare environments, contributing to a better understanding of how to leverage these networks for improved outcomes in patient care and organizational efficiency.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251393489"},"PeriodicalIF":0.7,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453720","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

A new governance of patient flows for hospital and community care. Impact on emergency department overcrowding and workload. 医院和社区护理病人流动的新治理。对急诊室过度拥挤和工作量的影响。

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Health Services Management Research Pub Date : 2025-11-04 DOI: 10.1177/09514848251393484

Eugenia Dal Bo, Franco Cominotto, Antonella Geri, Marco Spanò, Alessandro Cuda, Gianfranco Sanson

{"title":"A new governance of patient flows for hospital and community care. Impact on emergency department overcrowding and workload.","authors":"Eugenia Dal Bo, Franco Cominotto, Antonella Geri, Marco Spanò, Alessandro Cuda, Gianfranco Sanson","doi":"10.1177/09514848251393484","DOIUrl":"https://doi.org/10.1177/09514848251393484","url":null,"abstract":"Emergency Department (ED) overcrowding is a global challenge, and although tailored local interventions are recommended, their effectiveness remains unclear. This retrospective study evaluated the impact of patient flow governance interventions on ED overcrowding at a large academic hospital. A three-phase (input-throughput-output) model was adopted to analyze factors affecting both static and dynamic indicators of ED overcrowding. Two 6-month periods (2019 vs 2023) were compared, accounting for organizational changes implemented between 2019 and 2022. Over 80% of ED visits involved lower-acuity conditions, and more than 40% of patients were aged over 65 years. ED stays longer than 24 h increased by 637%, whereas medical ward admissions decreased by 31.2% and the daily average number of off-unit admissions declined by 94.3%. The ED discharge rate rose by 3.3%, accompanied by a 200% increase in transfers of frail patients to community facilities. The overall self-discharge rate fell by 3.4%, even though the proportion of patients leaving before being seen increased by 15%. Organizational strategies focusing on throughput and output were associated with fewer hospital admissions and a substantial reduction in off-unit admissions, but these gains came at the cost of increased ED overcrowding and workload.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251393484"},"PeriodicalIF":0.7,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446057","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

An exploratory study on attributes and benefits of innovation in academic medical centers: Evidence from Careggi University Hospital. 学术型医疗中心创新属性与效益的探索性研究：来自卡雷吉大学医院的证据。

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Health Services Management Research Pub Date : 2025-11-03 DOI: 10.1177/09514848251393486

Anna Romiti, Mario Del Vecchio, Salvatore Zimmitti, Daniela Matarrese

{"title":"An exploratory study on attributes and benefits of innovation in academic medical centers: Evidence from Careggi University Hospital.","authors":"Anna Romiti, Mario Del Vecchio, Salvatore Zimmitti, Daniela Matarrese","doi":"10.1177/09514848251393486","DOIUrl":"https://doi.org/10.1177/09514848251393486","url":null,"abstract":"The significance of investigating innovation in academic medical centers has been underscored, as they are recognized as leaders in frontline innovation and accelerators of healthcare advancement. The factors that contribute to innovation success, particularly those associated with benefits, can be identified by examining innovation attributes in relation to innovation process stages. This study aimed to understanding the innovation process by identifying the key factors that characterize innovation and their outcomes in academic medical centers. The central research questions were: what are the main attributes of innovation in an academic medical center? and which innovation attributes influence the outcomes of innovation in an academic medical center? Clinical directors from one academic medical center in Italy, Careggi University Hospital, responded to a questionnaire. Exploratory factor and regression analyses were performed to analyze the data. The findings highlighted the crucial role of middle managers in promoting and developing significant high-quality innovations. Our study deepens the innovation attribute framework and enables a better understanding of the relationship between attributes and benefits in the healthcare context. From a practical perspective, our study equips academic medical center administrators with a tool to evaluate innovation attributes and their relationship with outcomes, enabling better leverage of the potential benefits.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251393486"},"PeriodicalIF":0.7,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439530","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

Exploring cost changes with time-driven activity-based costing after service delivery redesign in Dutch maternity care. 探索荷兰孕产妇护理服务重新设计后以时间驱动的活动成本计算的成本变化。

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Health Services Management Research Pub Date : 2025-11-01 Epub Date: 2024-07-23 DOI: 10.1177/09514848241265770

Maud van den Berg, Hilco van Elten, Julia Spaan, Arie Franx, Kees Ahaus

{"title":"Exploring cost changes with time-driven activity-based costing after service delivery redesign in Dutch maternity care.","authors":"Maud van den Berg, Hilco van Elten, Julia Spaan, Arie Franx, Kees Ahaus","doi":"10.1177/09514848241265770","DOIUrl":"10.1177/09514848241265770","url":null,"abstract":"The implementation of Value-Based Healthcare (VBHC) has spread across international healthcare systems, aiming to improve decision-making by combining information about patient outcomes and costs of care. Time-Driven Activity-Based Costing (TDABC) is introduced as a pragmatic yet accurate method to calculate costs of care pathways. It is often applied to demonstrate value-improving opportunities, such as interventions aimed at service delivery redesign. It is imperative for healthcare managers to know whether these interventions yield the expected outcome of improving patient value, for which TDABC is also suitable. However, its application becomes more complex and labour intensive if the intervention extends beyond activity-level changes in existing care pathways, to the implementation of entirely new care pathways. The complexity arises from the potential influence of such interventions on the costs of related care pathways. To fully comprehend the impact of such interventions on organizational costs, it is important to include these factors in the cost calculation. Given the substantial effort required for this analysis, this may explain the limited number of prior TDABC studies with similar objectives. This methodological development paper addresses this gap by offering a pragmatic enrichment of the TDABC methodology. This enrichment is twofold. First, it provides guidance on calculating a change in costs without the need for a total cost calculation. Second, to secure granularity, a more detailed level of cost-allocation is proposed. The aim is to encourage further application of TDABC to conduct financial evaluations of promising interventions in the domain of VBHC and service delivery redesign.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"219-227"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749233","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

Primary care calls for more. 初级保健需要更多。

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Health Services Management Research Pub Date : 2025-11-01 Epub Date: 2025-08-26 DOI: 10.1177/09514848251374496

Federico Lega

引用次数: 0

Exploring the impact of acquisition on quality of care among US home health agencies. 探索获取对美国家庭保健机构护理质量的影响。

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Health Services Management Research Pub Date : 2025-11-01 Epub Date: 2025-05-03 DOI: 10.1177/09514848251339735

Debra Winberg, Jillian Torres

{"title":"Exploring the impact of acquisition on quality of care among US home health agencies.","authors":"Debra Winberg, Jillian Torres","doi":"10.1177/09514848251339735","DOIUrl":"10.1177/09514848251339735","url":null,"abstract":"Background: Throughout the United States and Europe, the home health care industry is rapidly consolidating, with merger and acquisition (M&A) activity on the rise.Purpose: The consolidation of the industry raises questions about the impact that diminished competition may have on the quality of care being delivered.Research Design: This study utilizes a weighted, staggered difference-in-differences analysis.Study Sample: This study examines the impact of home health agency acquisition on quality of care among a sample of 10,184 home health agencies across the United States.Analysis: Utilizing publicly available data from the Outcome and Assessment Information Set (OASIS) and the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) from 2018 to 2022, this study investigates changes in clinical outcomes, organizational process measures, and patient experience.Results: The findings suggest there is a modest 1.07 percentage point improvement in process measures post-acquisition, but no significant changes in outcome or patient experience measures among the 169 agencies that were acquired during the study period.Conclusion: These findings suggest that, while integration has the potential to modestly improve home health process efficiency, there is very little benefit to patients.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"211-218"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029789","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

Role of community health needs and assets assessment in promoting PHC-oriented models of care. 社区卫生需求和资产评估在促进以初级保健为导向的护理模式中的作用。

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Health Services Management Research Pub Date : 2025-11-01 Epub Date: 2025-08-07 DOI: 10.1177/09514848251365547

Hamid Ravaghi, Zhaleh Abdi, Samar Elfeky, Maha El-Adawy, Federico Lega, Awad Mataria

{"title":"Role of community health needs and assets assessment in promoting PHC-oriented models of care.","authors":"Hamid Ravaghi, Zhaleh Abdi, Samar Elfeky, Maha El-Adawy, Federico Lega, Awad Mataria","doi":"10.1177/09514848251365547","DOIUrl":"10.1177/09514848251365547","url":null,"abstract":"The Primary Health Care (PHC) approach is essential to ensuring that individuals and communities receive quality health services without financial hardship, thereby advancing Universal Health Coverage (UHC). PHC-oriented models of care promote people-centered services that are accessible, comprehensive, and responsive to the needs of individuals and communities. However, practical tools and approaches are needed to guide the shift from traditional disease-based models to integrated, people-centered systems tailored to diverse and evolving population needs. To facilitate this transition, the WHO Regional Office for the Eastern Mediterranean (EMRO) developed a Community Health Needs and Assets Assessment (CHNAA) guide to assist member states in integrating community voices into local health planning and decision-making, and aligning services with identified community priorities to advance PHC-oriented care. This perspective paper, grounded in a review of literature, policy guidance, and regional implementation experiences, outlines the rationale behind the guide, its core principles, and its potential to support health system reforms toward more resilient and equitable care in the Eastern Mediterranean Region (EMR).","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"228-231"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800543","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