Health Services Management Research最新文献

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Toward a universalistic behavioural model of perceived managerial and leadership effectiveness for the health services sector. 建立保健服务部门管理和领导效能的普遍行为模型。
IF 2.1
Health Services Management Research Pub Date : 2023-05-01 DOI: 10.1177/09514848211065462
Robert G Hamlin, Carlos E Ruiz, Jenni Jones, Taran Patel
{"title":"Toward a universalistic behavioural model of perceived managerial and leadership effectiveness for the health services sector.","authors":"Robert G Hamlin,&nbsp;Carlos E Ruiz,&nbsp;Jenni Jones,&nbsp;Taran Patel","doi":"10.1177/09514848211065462","DOIUrl":"https://doi.org/10.1177/09514848211065462","url":null,"abstract":"<p><p>Much management and leadership development provision for healthcare professionals has been the subject of considerable criticism, and there have been numerous calls for training programmes explicitly focused on the specific managerial (manager/leader) behaviours healthcare managers, physician leaders and nurse managers need to exhibit to be perceived effective. The aim of our multiple cross-case/cross-nation comparative study has been to: i) identify similarities and differences between the findings of published qualitative critical incident studies of effective and ineffective managerial behaviour observed within British, Egyptian, Mexican and Romanian public hospitals, respectively, and ii) if possible, deduce from the identified commonalities a healthcare-related behavioural model of perceived managerial and leadership effectiveness. Adopting a philosophical stance informed by pragmatism, epistemological instrumentalism and abduction, we used realist qualitative analytic methods to code and classify into a maximum number of discrete behavioural categories empirical source data obtained from five previous studies. We found high degrees of empirical generalization which resulted in the identification of five positive (<i>effective</i>) and four negative (<i>ineffective</i>) behavioural dimensions (BDs) derived, respectively, from 14 positive and 9 negative deduced behavioural categories (BCs). These BDs and underpinning BCs are expressed in the form of an emergent two-factor universalistic behavioural model of perceived managerial and leadership effectiveness. We suggest the model could be used to critically evaluate the relevance and appropriateness of existing training provision for physician leaders, nurse managers and other healthcare managers/leaders in public hospitals or to design new explicit training programmes informed and shaped by healthcare-specific management research, as called for in the literature.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 2","pages":"89-101"},"PeriodicalIF":2.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315382","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
Causing harm but doing good: Recognizing and overcoming the burden of necessary evil enactment in healthcare service professions. 害而为善:认识和克服医疗服务行业必要的恶立法负担。
IF 2.1
Health Services Management Research Pub Date : 2023-05-01 DOI: 10.1177/09514848221109833
Meena Andiappan
{"title":"Causing harm but doing good: Recognizing and overcoming the burden of necessary evil enactment in healthcare service professions.","authors":"Meena Andiappan","doi":"10.1177/09514848221109833","DOIUrl":"https://doi.org/10.1177/09514848221109833","url":null,"abstract":"<p><p>Necessary evils - defined as acts that cause physical, psychological, or emotional harm to victims but are for the greater good of either the victim or society - are an everyday occurrence in the healthcare industry across the globe and across healthcare service professions. Healthcare professionals are tasked with behaviors that result in pain and suffering (e.g. nurses providing shots to patients; oncologists communicating cancer diagnoses) for the betterment of their patients and stakeholders. Although these behaviors are professionally mandated, they can also be cognitively and psychologically taxing for enactors. The current conceptual paper explores the undesired effects of performing necessary evils and proposes various actions through which healthcare organizations can reduce the negative repercussions of necessary evil enactment on healthcare service professionals.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 2","pages":"153-159"},"PeriodicalIF":2.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/43/10.1177_09514848221109833.PMC10080367.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9646954","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: 1
Benefits, Barriers and Determinants of Clinical Pathway Use in Germany, Austria and Switzerland. A pilot study. 德国、奥地利和瑞士临床路径使用的益处、障碍和决定因素。一项初步研究。
IF 2.1
Health Services Management Research Pub Date : 2023-05-01 DOI: 10.1177/09514848221107485
Elisabeth Noehammer, Matthias Ponweiser, Tobias Romeyke, Florian Eibinger
{"title":"Benefits, Barriers and Determinants of Clinical Pathway Use in Germany, Austria and Switzerland. A pilot study.","authors":"Elisabeth Noehammer,&nbsp;Matthias Ponweiser,&nbsp;Tobias Romeyke,&nbsp;Florian Eibinger","doi":"10.1177/09514848221107485","DOIUrl":"https://doi.org/10.1177/09514848221107485","url":null,"abstract":"<p><strong>Background: </strong>Performance-oriented financing of healthcare aims at demand-based and efficient resource allocation. Often, clinical pathways (CPs) are introduced in this context.</p><p><strong>Purpose: </strong>For CP success (a) the degree of utilization of and divergence, (b) cost effects and (c) health professionals' acceptance rate of and satisfaction are relevant. There are gaps in research regarding these issues in general, and more specifically in the German speaking part of Europe.</p><p><strong>Methodology/approach: </strong>Employing a two-stage mixed-methods pilot study, we studied (a) and (b) quantitatively in Germany, Austria, and Switzerland, and (c) qualitatively in Germany and Austria.</p><p><strong>Results: </strong>Many hospitals already implemented CPs, but the utilization varies. They are expected to yield middle-range savings, but intangible benefits are more important. In general, employees are in favor of CPs, but several conditions need to be met, e.g. adaptability to local requirements.</p><p><strong>Conclusion: </strong>Linking the results to the Consolidated Framework for Implementation Research showed many criteria are covered, which might lead to the positive evaluations, but also highlights the complexity of the intervention.</p><p><strong>Practice implication: </strong>As enhanced acceptance rates are expected to lead to higher benefits and vice versa, management team should safeguard employee participation and perceived benefits in all phases of the CP cycle.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 2","pages":"119-126"},"PeriodicalIF":2.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/b1/10.1177_09514848221107485.PMC10080374.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9646974","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
Contextual factors and business strategy choice: The case of us hospitals. 情境因素与经营策略选择:以美国医院为例。
IF 2.1
Health Services Management Research Pub Date : 2023-05-01 DOI: 10.1177/09514848221115093
Akbar Ghiasi, Robert Weech-Maldonado, Ferhat Zengul, Neeraj Puro
{"title":"Contextual factors and business strategy choice: The case of us hospitals.","authors":"Akbar Ghiasi,&nbsp;Robert Weech-Maldonado,&nbsp;Ferhat Zengul,&nbsp;Neeraj Puro","doi":"10.1177/09514848221115093","DOIUrl":"https://doi.org/10.1177/09514848221115093","url":null,"abstract":"<p><p>US hospitals are struggling with how to compete and remain viable in an increasingly turbulent and competitive environment. Using Porter's generic strategies and resource dependence theory, this study examined the relationship between environmental factors and business strategy choice among U.S. hospitals. The study used longitudinal data from 2006 to 2016 of US urban, general acute care hospitals from the American Hospital Association Annual Survey, Medicare cost reports, and Area Health Resource File. Multinomial regression was used to analyze the data. and Discussion: Our findings showed four types of hospital strategy: cost-leadership, differentiation, hybrid, and stuck-in-the-middle. A greater number of physicians (county-level) increases the likelihood of pursuing differentiation and hybrid strategy. On the other hand, a higher older adult population (65 years+) increases the likelihood of pursuing a cost-leadership strategy. Similarly, lower competition and higher Medicare Advantage penetration increases the likelihood of pursuing cost-leadership over hybrid strategy. An increase in the unemployment rate decreases the likelihood of pursuing differentiation and cost-leadership strategies versus the hybrid strategy. Finally, hospitals pursuing a differentiation strategy tended to be larger, teaching, and not-for-profit. The results showed the importance of environmental and organizational factors in predicting the strategy choice of hospitals.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 2","pages":"127-136"},"PeriodicalIF":2.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9261455","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
Allied health clinical supervision: An opportunity lost. 联合医疗临床监督:一个失去的机会。
IF 2.1
Health Services Management Research Pub Date : 2023-05-01 DOI: 10.1177/09514848221100747
Nicky Baker, Jill Garner, Liz Kapur, Belinda Lange
{"title":"Allied health clinical supervision: An opportunity lost.","authors":"Nicky Baker,&nbsp;Jill Garner,&nbsp;Liz Kapur,&nbsp;Belinda Lange","doi":"10.1177/09514848221100747","DOIUrl":"https://doi.org/10.1177/09514848221100747","url":null,"abstract":"<p><p>This study investigated clinical supervision with Allied Health professionals in a public health setting. Staff perceptions and experiences were explored through focus group discussions. Key themes identified that supervisees \"tip-toe into complexity\" by engaging in reflective practice for incremental personal and professional development. In contrast, supervisors identified that reflexivity was required for the opportunity to \"develop at a deeper level\". Offering a choice of supervisor and providing supervisor training enhanced supervision experiences. Challenges to effective supervision were identified. Competing priorities, inconsistent modes of delivery, major organisational change and the role of clinical supervision in line with professional development confounded the experiences. Health managers could improve the processes and outcomes by implementing consistency with approach, timing, documentation, language, and structure of Clinical Supervision.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 2","pages":"102-108"},"PeriodicalIF":2.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315389","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
Reducing hospital admissions and transfers to long-term inpatient care: A systematic literature review. 减少住院和转移到长期住院治疗:系统的文献综述。
IF 2.1
Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848211068620
Stephan Herberg, Frank Teuteberg
{"title":"Reducing hospital admissions and transfers to long-term inpatient care: A systematic literature review.","authors":"Stephan Herberg,&nbsp;Frank Teuteberg","doi":"10.1177/09514848211068620","DOIUrl":"https://doi.org/10.1177/09514848211068620","url":null,"abstract":"<p><p>Individuals in need of long-term care and their relatives prefer to receive and give care in their domestic environment for as long as possible. Residential long-term care is to be avoided for as long as possible. To achieve this goal, the care setting must be optimally oriented to the needs of the person in need of care. Moreover, relatives who provide care must be professionally supported. The Regional Care Competence Center (ReKo), launched on October 1, 2019, is a quasi-experimental study (two groups and pre-post design), funded by the Innovation Fund. As part of the ReKo project, people in need of care and their relatives are assisted by a case management (CM) system. An independent CM, supported by an IT network that includes the most important service providers, is to establish a comprehensive CM for people in need of care. Based on a literature review, this paper aimed to take a conceptual approach to the ReKo project by drawing on previous research and comparing the findings with the ReKo approach. The review considered CM projects that defined avoidance of hospitalization and/or delay in the transition of care recipients to long-term inpatient care as endpoints. Using PubMed and Google Scholar, the study screened 270 articles, abstracted and quality-assessed data, and included eight randomized clinical trials, two other studies, and seven reviews in the analysis. The review results and ReKo approaches are presented along the dimensions of clinical and medical benefits, community and public health benefits, economic benefits, and political and legislative benefits. CM organizations will continue to be established internationally in aging societies. The questions of improving quality of care, avoiding service costs, and the costs of establishing a CM must be raised, even if clear evidence is difficult to provide.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"10-24"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10669641","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
Effect of surgeon experience on technical efficiency. 外科医生经验对技术效率的影响。
IF 2.1
Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221080688
Yoshinori Nakata, Yuichi Watanabe, Hiroshi Otake
{"title":"Effect of surgeon experience on technical efficiency.","authors":"Yoshinori Nakata,&nbsp;Yuichi Watanabe,&nbsp;Hiroshi Otake","doi":"10.1177/09514848221080688","DOIUrl":"https://doi.org/10.1177/09514848221080688","url":null,"abstract":"Surgeon experience certainly improves their technical efficiency although it also causes physiological changes with aging. The authors hypothesized that surgeons’ technical efficiency improves with increasing experience up to a point where it then decreases, which is a concave relationship. The authors collected data from all the surgical procedures performed at University Hospital from April through September in 2013–19. The dependent variable was defined as surgeons’ technical efficiency scores that were calculated using output-oriented Charnes–Cooper–Rhodes model of data envelopment analysis. Inputs were defined as (1) the number of assistants and (2) the duration of surgical operation. The output was defined as the surgical fee for each surgery. Surgeon experience was defined as the number of years since medical school graduation. Five control variables were selected: surgical volume, gender, academic rank, surgical specialty, and the year of surgery. Multiple regression analysis using pooled and random-effects Tobit models was performed for our panel data. Totally 20,375 surgical procedures performed by 264 surgeons in 42 months were analyzed. The coefficients of experience and the square of experience were not significantly different from zero. The other coefficients were also insignificant. Surgeons’ technical efficiency does not have a concave relationship with experience.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"34-41"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10570444","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
Analysis of the effect of patients' health status on efficiency: Application of data envelopment analysis in healthcare. 患者健康状况对效率的影响分析:数据包络分析在医疗保健中的应用。
IF 2.1
Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848211065464
Tamás Koltai, Rita V Dénes, Zoltán Dénes
{"title":"Analysis of the effect of patients' health status on efficiency: Application of data envelopment analysis in healthcare.","authors":"Tamás Koltai,&nbsp;Rita V Dénes,&nbsp;Zoltán Dénes","doi":"10.1177/09514848211065464","DOIUrl":"https://doi.org/10.1177/09514848211065464","url":null,"abstract":"<p><p>The effective and efficient operation of public healthcare systems is more and more important as a consequence of the increasing amount of money spent on their operation. For this reason, accurate and science-based efficiency information is needed for managers and healthcare policy makers. The evaluation of the efficiency in this sector is particularly difficult because several measures and indicators are used. Data envelopment analysis (DEA) can provide aggregate and overall measures of efficiency. The purpose of this paper is the examination of the efficiency of in-patient rehabilitation units curing musculoskeletal disorders in Hungary. The research presented focuses on rehabilitation units which attend to patients recovering from stroke or other acquired brain injuries. Output-oriented, slack-based DEA models are applied for the evaluation of in-patient rehabilitation units using data of a national survey. The novelty of the method presented is the consideration of the change in patients' functional status when efficiency is evaluated using DEA.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"2-9"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10624239","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
Editorial. 社论。
IF 2.1
Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848231151891
Federico Lega
{"title":"Editorial.","authors":"Federico Lega","doi":"10.1177/09514848231151891","DOIUrl":"https://doi.org/10.1177/09514848231151891","url":null,"abstract":"","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"1"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9139872","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
Do policies affect management? Evidence from a survey of clinicians of the Italian National Health Service. 政策会影响管理吗?来自意大利国家卫生服务临床医生调查的证据。
IF 2.1
Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848211073521
Giovanni Fattore, Dino Numerato, Domenico Salvatore
{"title":"Do policies affect management? Evidence from a survey of clinicians of the Italian National Health Service.","authors":"Giovanni Fattore,&nbsp;Dino Numerato,&nbsp;Domenico Salvatore","doi":"10.1177/09514848211073521","DOIUrl":"https://doi.org/10.1177/09514848211073521","url":null,"abstract":"<p><p>Since the early 1990s, New Public Management ideas have deeply influenced reforms and their implementation in the Italian NHS. We compare doctors' perceptions about management systems in two Italian regions which differ in the dominant values of the regional political environment. In total 220 doctors, orthopaedists and cardiologists, working in public hospitals in Lombardy and Emilia-Romagna, were surveyed. Doctors in Emilia-Romagna perceived their organization to be more managerially driven in comparison to their colleagues in Lombardy. Doctors from Lombardy perceived their professional freedom to be higher, regardless of their specialization. The divergence of professionals' perception between these two Italian regions, which operate within the same Beveridge model, shows that dominant values of regional politics may have tangible effects on hospital management.</p>","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":"36 1","pages":"25-33"},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9119731","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
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