Health Services Management Research最新文献

{"title":"Testing contingency theory to drive organizational change in community care: A case study in the Emilia Romagna Region.","authors":"Irene Gabutti, Maria Pia Fantini, Chiara Reno","doi":"10.1177/09514848241265749","DOIUrl":"10.1177/09514848241265749","url":null,"abstract":"<p><p>PurposeThe objective is to test contingency theory among \"community homes\" in a region in Northern Italy. Community homes constitute an emerging key setting in the Italian primary healthcare system and are emblematic of the most recent organizational solutions in primary care across countries.MethodsA case study was carried out through semi-structured interviews administered in community homes to key professionals. Results were validated in two communities of practices.FindingsSeveral elements of organizational and managerial variability were detected across the sample of community homes involved in the study, although they were all responding to the same regulations and normative pressures.Original valueThe study provides preliminary evidence on the role of contingency theory in the primary healthcare sector, shedding light on its characteristics and providing food for thought on the extent to which organizational variability should be supported, rather than hindered.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"186-192"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724683","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":"Hybrid managers in an evolving healthcare: Does gender matter?","authors":"Marco Sartirana, Roberta Montanelli","doi":"10.1177/09514848241295584","DOIUrl":"10.1177/09514848241295584","url":null,"abstract":"<p><p>IntroductionHybrid managers have the potential to respond to the need for more integrated, responsive and accountable healthcare. Scholars have studied the antecedents of hybridization, but the role of gender has been neglected. Therefore, we study whether and how gender impacts on the way in which medical professionals exercise their managerial role.MethodsWe adopted a qualitative approach in order to gain an in-depth understanding of the specificities of women hybrids. Data was collected through semi-structured interviews, focusing on hybrids in Italy in the field of neurology.ResultsWe found that women hybrids show specific abilities and motivations, but they also encounter a specific lack of opportunities. Women hybrid managers appear well positioned to foster the evolution of professionalism, but healthcare organizations should implement policies and practices to effectively support them.ConclusionWhile existing research has treated hybrid managers as a homogenous group, we underline the specificities of women hybrids. They can support the evolution of healthcare organizations towards logics of service integration, user centricity, and staff engagement. Therefore, our findings have important theoretical and practical implications for health policy and management.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"193-201"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590898","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":"Health and well-being of staff in substance use services: The case of Scotland.","authors":"Joshua Bird, Sarah Henning","doi":"10.1177/09514848251318296","DOIUrl":"10.1177/09514848251318296","url":null,"abstract":"<p><p><b>Background:</b> Addressing high rates of drug and alcohol mortality requires a sustained commitment to supporting a resilient and skilled substance use workforce. Employee well-being in wider health and social care has been the subject of much empirical research, however there is a dearth of evidence specific to professionals working in substance use services.<b>Methods:</b> Data were derived from a cross-sectional survey of publicly-funded drug and alcohol services operating in Scotland during autumn 2021. Nested semi-log regression models estimated the associations between workplace characteristics and workforce composition, and the main outcome measure: non-Covid sickness absence. Qualitative data were analysed using thematic analysis.<b>Results:</b> 88 services, representing 43% of Scotland's drug and alcohol services, were included in the study. Factors significantly and positively associated with non-Covid sickness absence in multivariable analysis included average caseload per whole-time equivalent and number of whole-time equivalent clinical roles. Descriptive statistics show that vacancy rates and caseloads are comparatively higher in statutory services, and are also higher for clinical than non-clinical positions.<b>Conclusion:</b> This study revealed that and burnout leading to sickness absence are serious issues for frontline staff in drug and alcohol services, and these worsened during the Covid-19 pandemic. This research provides a foundation for validating the current findings via future large-scale longitudinal studies, and improving the well-being of people delivering health and social care services in substance use settings.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"202-210"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257009","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":"Onboarding and early employment experiences in healthcare: Implications for retention.","authors":"Nicole Nagib, Natalie Nagib, Lindy Grief Davidson, Kelley Marie Fildew, Donna Lee Gambino","doi":"10.1177/09514848251384273","DOIUrl":"https://doi.org/10.1177/09514848251384273","url":null,"abstract":"<p><p>ObjectiveIn the United States healthcare system, employee retention is impacted by a range of factors including work environment, culture, remuneration, and managerial relationships. Leaders who understand these dynamics are crucial for enhancing retention and improving patient outcomes. This study aimed to identify key job satisfaction indicators-such as onboarding, comfort, productivity, job expectations, and perceived challenge-across various employment stages within a multi-hospital system in the Midwestern United States.Theoretical FrameworkGuided by Job Embeddedness Theory, this study examined how employees' links to the organization, sense of fit, and potential sacrifices associated with leaving influenced retention patterns.MethodsA quantitative descriptive-comparative design was used. MANOVA and one-way ANOVAs were conducted to evaluate differences among new employees at 30, 60, and 90+ days of employment based on five retention-related variables.ResultsStatistically significant differences emerged across all five indicators. Employees at 30 days were more likely to report that their job met expectations, felt productive, and were satisfied with onboarding. However, job satisfaction and comfort declined substantially by 60 and 90+ days, suggesting potential gaps in ongoing support. These patterns provide empirical support for Job Embeddedness Theory by demonstrating how employees' sense of fit and organizational links initially strengthen retention intentions but weaken without sustained reinforcement, highlighting the importance of continuous integration strategies.ConclusionWhile early onboarding experiences were positive, findings highlight a marked decline in satisfaction over time. Recommendations include enhancing long-term engagement strategies, aligning job expectations with role realities, fostering leadership engagement, and offering continuous professional development tailored to employee tenure. Healthcare leaders who prioritize sustained employee support, clear communication, and adaptive retention strategies may improve workforce stability, organizational performance, and ultimately, patient care outcomes.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251384273"},"PeriodicalIF":0.7,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318750","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":"At the core of the balanced scorecard: Understanding cause-and-effect relationships in health and social care.","authors":"Gaia Bassani, Luca Piubello Orsini, Chiara Leardini","doi":"10.1177/09514848251374955","DOIUrl":"https://doi.org/10.1177/09514848251374955","url":null,"abstract":"<p><p>Healthcare organizations increasingly use performance management systems to ensure flexibility, service quality, and cost efficiency. In this context, the balanced scorecard (BSC) represents one of the most popular performance management tools for achieving these objectives. A crucial element that makes it widely employed is that it allows measures and perspectives to be linked through clearly defined cause-and-effect relationships. Nevertheless, despite its centrality in implementing BSC, a discussion regarding the effective interpretation of cause-and-effect relationships has sparked. In particular, the previous literature emphasizes the dichotomy between non-statistical causality, i.e., based on logical or finality relationships, and causality tested statistically. This study aims to investigate the nature of causal relationships between indicators and perspectives of BSC through a systematic literature review of studies conducted in the health and social care contexts. Findings reveal that both perspectives of causality can be identified; however, numerous directions for future research are possible for both. Overall, there is a need for more attention to theoretical perspectives supporting causal analysis. Furthermore, although the development of quantitative methodologies to support empirical analyses is remarkable, there is room for further improvement. Finally, the research focuses mainly on the organizational level, overlooking the role of BSC causality at other levels.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251374955"},"PeriodicalIF":0.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973607","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":"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":0.7,"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":0.7,"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":0.7,"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":0.7,"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":0.7,"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}