Anu Vehkamäki, Märt Vesinurm, Riina-Riitta Helminen, Olli Halminen, Paul Lillrank
{"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":0.7,"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":"Understanding hospital quality: Empirical insights from patients' perspectives in the growing hospital sector.","authors":"Aulia Vidya Almadana, Suharnomo Suharnomo, Mirwan Surya Perdhana","doi":"10.1177/09514848251361317","DOIUrl":"https://doi.org/10.1177/09514848251361317","url":null,"abstract":"<p><p><b>Background</b>: The rapid expansion of the hospital sector in Indonesia, fueled by the National Health Insurance Program (JKN), emphasizes the need for improved service quality. Understanding patient perceptions of hospital service quality is crucial for enhancing satisfaction and optimizing healthcare delivery.<b>Purpose</b>: This study aims to evaluate hospital service quality from the patient's perspective, focusing on empathy, safety, tangibility, perceived quality, and patient expectations. It also investigates the moderating role of patient expectations on the relationship between perceived service quality and satisfaction.<b>Research Design</b>: A quantitative approach using structural equation modeling (SEM) was employed, with confirmatory factor analysis (CFA) to assess construct validity.<b>Study Sample</b>: 355 hospital patients from Jakarta, Indonesia, were surveyed using a 7-point Likert scale.<b>Results</b>: Empathy significantly enhanced perceived service quality, while safety and tangibility had negligible effects. Perceived quality was a key driver of patient satisfaction. Additionally, patient expectations moderated the relationship between perceived service quality and satisfaction, with low expectations leading to greater satisfaction at moderate service levels.<b>Conclusions</b>: The study underscores empathy's critical role in improving perceived quality and satisfaction. It highlights the importance of managing patient expectations and fostering empathy in healthcare settings to boost patient satisfaction.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848251361317"},"PeriodicalIF":0.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733819","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":"Financial management, efficiency, and care quality: A systematic review in the context of Health 4.0.","authors":"Ricardo do Carmo Filho, Pedro Pereira Borges","doi":"10.1177/09514848241275783","DOIUrl":"10.1177/09514848241275783","url":null,"abstract":"<p><p>This article investigates the intersection between innovation, Health 4.0, and financial management in the healthcare industry, emphasizing the importance of operational efficiency and quality of care. The study aims to analyze how financial management processes in healthcare relate to Health 4.0 and enhance care quality. It begins with a thorough theoretical grounding, proposing a framework that connects Health 4.0 with financial management practices. A systematic review of the literature was conducted, identifying trends, challenges, and opportunities in the financial management of Health 4.0. The results highlight selected articles on responsible innovation, Health 4.0 technologies, investments in health, hospital efficiency, performance forecasting, and high-cost patient management. These articles were clustered into \"Data Analysis and Machine Learning in Healthcare\" and \"Health Management and Sustainability,\" providing a categorized understanding of the topics. The study reveals that Health 4.0 offers significant opportunities for process efficiency and cost reduction without compromising service quality. It highlights strategic advantages in addressing contemporary healthcare challenges by optimizing processes, improving financial projections, and incorporating advanced technologies efficiently. The successful implementation of Health 4.0 can lead to substantial improvements in service quality, adding value to patients and driving local economic development. This article offers valuable insights for healthcare professionals and managers, emphasizing the transformative potential of Health 4.0 and outlining strategies for its effective implementation. The clustering of articles provides a clearer understanding of current research in Health 4.0, contributing significantly to the field and guiding future research directions.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"107-119"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082215","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":"Factors influencing use of eHealth services during and after the COVID-19 pandemic.","authors":"Korina Katsaliaki","doi":"10.1177/09514848241275777","DOIUrl":"10.1177/09514848241275777","url":null,"abstract":"<p><p>ObjectivesThe rapid advancement of information and communication technologies has made eHealth applications increasingly available and accessible. The COVID-19 pandemic has accelerated the need for remote health service provision. This research aims to explore the usage, perceptions, and knowledge of eHealth interventions during and after the COVID-19 pandemic.MethodsA cross-sectional survey was conducted in 2021 (during the pandemic) and 2023 (post-pandemic) using a structured questionnaire based on the Technology Acceptance Model (TAM) and the eHealth Literacy Scale (eHEALS). The survey, conducted in Greece, included 638 participants in total (277 in 2021 and 361 in 2023). Structural equation modeling was employed to assess the factors influencing eHealth adoption.ResultsThe findings indicate a slight increase in positive perceptions of eHealth usefulness, intention to use, and actual usage over the 2 years. However, concerns remain regarding the ease of use and eHealth literacy. eHealth literacy significantly predicts the perceived usefulness and ease of use of eHealth services, both of which predict the intention to use them. Additionally, higher education levels are positively associated with eHealth literacy, while older age is negatively associated with ease of use. Gender did not significantly impact these factors. These findings were consistent across both surveys.ConclusionsPolicy-makers should focus on simplifying eHealth services, removing technical barriers, and enhancing the population's eHealth literacy to promote wider adoption of eHealth services.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"97-106"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037333","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":"How excellent can centres of excellence be? The impact of prevalence on service quality.","authors":"David Martin Foreman","doi":"10.1177/09514848241270844","DOIUrl":"10.1177/09514848241270844","url":null,"abstract":"<p><p>Centres of Excellence (CEs) are thought to provide better quality services for their speciality than Generic Services (GS). However, clinical test theory suggests this may arise from differences in the prevalence of these specialities' conditions in their referral populations, which affects the services' ability to detect diagnoses accurately, even with similar diagnostic sensitivities and specificities. Furthermore, GS' insensitivity to rarer diagnoses is necessary to avoid serious overdiagnosis despite using skills equivalent to CEs. Good GS can perform as well as CEs for disorders of 15% to 20% or greater prevalence in their referral populations, depending on the Minimal Clinically Important Difference (MCID) decided for their diagnoses' positive predictive values or degree of bias. CEs are necessary for rare disorders and have a role in determining MCIDs and the sensitivity and specificity of new measures. Sensitivity, specificity, positive & negative predictive values, and true diagnostic prevalence should be routine outcome measures.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"120-126"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914254","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}
Jennifer Creese, John Paul Byrne, Edel Conway, Gerard O'Connor, Niamh Humphries
{"title":"\"They say they listen. But do they really listen?\": A qualitative study of hospital doctors' experiences of organisational deafness, disconnect and denial.","authors":"Jennifer Creese, John Paul Byrne, Edel Conway, Gerard O'Connor, Niamh Humphries","doi":"10.1177/09514848241254929","DOIUrl":"10.1177/09514848241254929","url":null,"abstract":"<p><p>The sharing of information and feedback directly from service-providing staff to healthcare organisational management is vital for organisational culture and service improvement. However, hospital doctors report feeling unable to communicate effectively with management to provide evidence and affect improvement, and this can impact job satisfaction, workplace relations, service delivery and ultimately patient safety. In this paper, we draw on data elicited from a Mobile Instant Messaging Ethnography (MIME) study involving 28 hospital doctors working in Irish hospitals, to explore the barriers preventing them from speaking up and effecting change, and the impact of this on staff morale and services. We identify three major barriers, consistent with previous literature, to effective feedback and communication: (1) organisational deafness, (2) disconnect between managers and frontline staff, and (3) denial of the narratives and issues raised. We draw these together to identify key implications from these findings for healthcare managers, and suggest policy and practice improvements.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"62-70"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180993","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}
{"title":"Institutional influences on healthcare service innovation: Lessons from German rehabilitation clinics.","authors":"Bettina Kriegl, Herbert Woratschek, Andrea Raab","doi":"10.1177/09514848241275788","DOIUrl":"10.1177/09514848241275788","url":null,"abstract":"<p><p>In view of the growing need for rehabilitation worldwide due to demographic changes and health trends, healthcare organizations are facing increasing pressure to innovate. This study focuses on the institutional dynamics shaping service innovation in orthopedic rehabilitation settings in Germany. Using Scott's framework of institutional pillars and carriers, we conduct a multiple case study analysis. Based on interviews with physicians and managers from six different clinics, conducted in two rounds and supplemented by secondary data analysis, we investigate the influence of regulative, normative, and cultural-cognitive institutions on healthcare service innovation. By distinguishing between the various institutional barriers and facilitators, our research provides valuable insights for healthcare practitioners and managers, equipping them with the necessary knowledge to effectively navigate and utilize the institutional environment.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"88-96"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005504","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}
Irene Gabutti, Lorena Martini, Daniele Pandolfi, Luigi Apuzzo, Domenico Mantoan
{"title":"Competing in the \"war for talent\" in nursing homes: A quantitative investigation.","authors":"Irene Gabutti, Lorena Martini, Daniele Pandolfi, Luigi Apuzzo, Domenico Mantoan","doi":"10.1177/09514848241270767","DOIUrl":"10.1177/09514848241270767","url":null,"abstract":"<p><p>PurposeThis study explores the characteristics of primary care organizations that are likely to attract and retain highly skilled professionals, meeting their expectations and increasing Person-Organization fit. Both \"hard\" dimensions (ownership) and organizational/managerial traits under the span of control of management are investigated. The objective is to raise awareness on how to mitigate unpopular features of primary healthcare organizations so to effectively compete in the war for talent.MethodsThis study has been carried out based on data extrapolated from a broader study conducted by the Italian National Agency for Regional Health Services and commissioned by the Italian Ministry of Health. Data deriving from Italian nursing homes was extrapolated from the broader public dataset and multiple regressions were carried out to detect associations between managerial variables and staff seniority.FindingsSeveral significant associations were detected, suggesting that both physicians and nurses are affected by some investigated variables when deciding where to work and for how long. While some of these are common to the two categories of professionals (e.g., the presence of a nursing director), others are not (e.g., the presence of internal training programs).Original valueThe implications of this study are related to the need of increasing awareness of managers of nursing homes on those features that are likely to increase their attractiveness and long-lasting appeal to professionals. This is a paramount topic in times in which the war for talent is strong. A lack of attention on this field may lead to the inability to attract and retain staff in primary care settings and, in turn, to implement strategic trends of change healthcare systems are facing in Italy and worldwide.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"80-87"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894578","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}