International Journal of Health Planning and Management最新文献

{"title":"What a State: Why the U.S. is Still Bad for Your Health (Policy).","authors":"Calum Paton","doi":"10.1002/hpm.70009","DOIUrl":"https://doi.org/10.1002/hpm.70009","url":null,"abstract":"<p><p>The second Trump administration's centrepiece legislation, the modestly-named Big Beautiful Bill, passed by the House of Representatives and going through the Senate at time of writing, offers an opportunity to reflect upon how the U.S. state affects health policy and the prospects for equitable access to affordable healthcare. Is the U.S. still an outlier (by comparison with Europe and much of the world), in that its many of its citizens are either uncovered, poorly covered or tenuously and only temporarily covered by health insurance? The answer is yes. And the chipping away at Obamacare and Medicaid by Trump 2.0 (learning from his failure to repeal Obamacare in 2017) as part of the Big Beautiful Bill, shows us that it is easier for the Right to dismantle progressive social legislation than it is for the Liberal-Left to assemble it. To understand why, and to revisit why the U.S. polity struggles to enact progressive healthcare reform, we have to understand the effect of the U.S. state (i.e. political structure) upon public policy. This article revisits the nature of that state, to depict the underlying causes of 'American exceptionalism' which are partly ideological but also more significantly institutional than often realised.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'What is Your Job?': A Qualitative Analysis of the Deployment, Utilisation, and Contribution of Support Workers in Diagnostic Imaging Services in England.","authors":"Sarah Etty, Beverly Snaith, Robert Appleyard, Julie Nightingale","doi":"10.1002/hpm.70005","DOIUrl":"https://doi.org/10.1002/hpm.70005","url":null,"abstract":"<p><p>Support workers (SWs) form the largest section of the NHS workforce, and the ongoing NHS workforce crisis underscores the need for their efficient utilisation. This study explored the deployment of imaging SWs within NHS radiology departments in England, forming part of a larger multiphase research project funded by the National Institute for Health Research (NIHR). It involved multi-centre case studies across nine radiology departments, employing a thematic analysis of focus groups and interviews with a range of radiology staff, including SWs themselves (n = 113). Results showed that recruitment of SWs was generally not challenging, however, retention was variable potentially due to limited opportunities for career progression and a lack of role understanding. Deployment strategies varied significantly across sites, which sometimes influenced SW effectiveness and were often selected for service need rather than SW development. Role scope was often unclear and training inconsistent which may exacerbate poor role understanding, and the lack of clear career pathways outside of professional registration conflicted with SWs' strong desire for progression. SWs are highly valued, crucial to operational efficiency and excellent patient care. Efficient deployment of SWs within NHS radiology services is crucial for alleviating workforce shortages and improving service delivery, however, this is impeded by the variability in role definition and deployment practices evidenced in this study. Standardising role titles, responsibilities, and training, and creating clear progression pathways could help to fully harness the capabilities of SWs in healthcare settings. National frameworks offer recommendations for standardisation, but this study suggests implementation remains inconsistent or delayed.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-of-Pocket Expenditure and its Determinants Amongst the Patients Undergoing Advanced Radiological Procedures in the Public Healthcare Facilities of Tamil Nadu, South India.","authors":"Dhanajayan Govindan, Suthanthira Kannan, Deivasigamani Kuberan, Arivarasan Barathi, Venmathi Elangovan, Afrith John Poul, Muneera Parveen, Marie Gilbert Majella, Yuvaraj Krishnamoorthy","doi":"10.1002/hpm.70006","DOIUrl":"https://doi.org/10.1002/hpm.70006","url":null,"abstract":"<p><strong>Background: </strong>Advanced radiological procedures, such as CT, MRI, and PET scans, are crucial for accurate diagnostics and treatment planning but often result in substantial out-of-pocket expenditures (OOPE) for patients, especially in developing countries like India. Despite progressive health policies in Tamil Nadu, the financial burden on patients undergoing these procedures in public healthcare facilities remains a concern. Hence, this study was done to assess the OOPE and its determinants amongst patients undergoing CT, MRI and PET scan procedures in public healthcare facilities of Tamil Nadu.</p><p><strong>Methods: </strong>This cross-sectional study analysed OOPE among 2415 patients undergoing advanced radiological procedures in public healthcare facilities across 12 districts in Tamil Nadu. A two-step sampling strategy was employed to select 23 healthcare facilities. Patient-level costs were calculated, including direct medical, direct non-medical, and indirect costs. Determinants of OOPE were assessed using log-linear regression models.</p><p><strong>Results: </strong>PET scans were the costliest procedure, with median total cost per patient of INR 12,150 (USD 147.14), primarily due to direct medical expenses. Median total costs per patient for CT and MRI scans were INR 1460 (USD 17.68) and INR 3250 (USD 39.36), respectively. Factors significantly associated with higher OOPE included urban residence (e^β = 1.13 for CT; 1.17 for MRI), higher socioeconomic status (e^β = 1.25 for Class I vs. V in CT; 1.45 for Class I vs. V in MRI), lack of insurance utilisation (e^β = 1.75 for CT; 3.73 for MRI), absence of insurance (e^β = 1.89 for CT; 3.85 for MRI), greater travel distance (e^β = 1.51 for CT; 1.56 for MRI), and longer waiting times (e^β = 1.21 for CT).</p><p><strong>Conclusions: </strong>The study reveals significant financial burdens on patients undergoing advanced radiological procedures, highlighting the need for policy reforms to enhance insurance coverage utilisation, reduce urban-rural disparities, and improve access to affordable care. Addressing these determinants is crucial for reducing OOPE and ensuring equitable access to essential diagnostic services.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Strategies for Inclusion of Value-Based Healthcare in Contract Negotiations in the Netherlands: Study Among Hospital and Insurer Executives.","authors":"Diogo L L Leao, Dennis van Veghel, Lise A M Moers, Wim Groot, Milena Pavlova","doi":"10.1002/hpm.70003","DOIUrl":"10.1002/hpm.70003","url":null,"abstract":"<p><strong>Background: </strong>This paper analyses why, despite its recognized importance, value-based healthcare (VBHC) has not gained more prominence in negotiations between health insurers and hospitals in the Netherlands.</p><p><strong>Methods: </strong>Data collected by interviews used a standardized questionnaire with closed- and open-ended questions. Respondents included hospital and insurer executives, and experts on VBHC in the Netherlands.</p><p><strong>Results: </strong>Hospital and insurer executives addressed issues of cost containment, volume management, and care availability. Despite recognising the potential of VBHC to enhance patient outcomes and experiences, reluctance persists due to uncertainties about cost-savings, its complexity, lack of data, and competing priorities. Hospital executives advocated experiments with VBHC, trust-building, and continuous evaluation, with strategies to standardise measures, enhance information technology (IT) infrastructure, promote data transparency, foster collaboration, and educate stakeholders. Participants also underlined the need for systemic change and governmental action.</p><p><strong>Conclusions: </strong>Negotiations mostly focus on cost containment and volume management. This reflects a systemic emphasis on immediate financial concerns over long-term value creation. The hesitancy in transitioning to VBHC underscores the need for collaborative strategies and systemic shifts to prioritise patient-centric care. External factors such as fee-for-service payment systems further complicate VBHC adoption, requiring governmental intervention and cultural transformation to align incentives and promote sustainable healthcare practices.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence and Corruption: Opportunities and Challenges in the Health Sector.","authors":"Paula Del Rey-Puech, Dina Balabanova, Martin McKee","doi":"10.1002/hpm.70002","DOIUrl":"https://doi.org/10.1002/hpm.70002","url":null,"abstract":"<p><p>Corruption in health systems diverts resources, erodes trust, and reduces service quality. Traditional oversight methods struggle to detect fraudulent patterns, but Artificial Intelligence (AI) offers new possibilities. AI can analyse large datasets to predict corruption risks and detect irregularities in procurement, insurance claims, and counterfeit medicines. Successful applications include AI-powered tools that flag suspicious transactions, expose bid-rigging in procurement, and identify fraudulent medical billing. AI can also complement other analytical tools to help track counterfeit drug supply chains through image recognition and network analysis. However, AI's impact depends on how it is deployed. Government-led AI initiatives may enhance transparency but risk reinforcing power imbalances or enabling authoritarian control. In contrast, civil society-driven efforts can empower citizens to hold authorities accountable but face challenges like limited data access and misinformation risks. Moreover, AI can also facilitate corruption in the health system through biased algorithms, deepfake propaganda, or manipulated AI-driven decision-making in resource allocation. Maximising AI's anti-corruption potential in healthcare requires investments in skilled personnel and data systems. AI should complement human oversight, with transparent auditing mechanisms to mitigate biases. Integrating blockchain and AI technologies may enhance accountability by securing procurement records and preventing data manipulation. While AI presents significant opportunities, its application to anti-corruption remains a political issue as much as a technological one. Careful governance, ethical and legal safeguards, and balanced implementation will determine whether AI combats corruption or exacerbates abuses.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Workers in Sub-Saharan Africa: Concurrent Skilled Health Worker Shortages and Under-Employment.","authors":"Pieternella Pieterse","doi":"10.1002/hpm.70001","DOIUrl":"https://doi.org/10.1002/hpm.70001","url":null,"abstract":"<p><p>In 2021, the World Health Organization (WHO) introduced the Health Workforce Support and Safeguards List, updating the 2010 WHO Global Code of Practice on the International Recruitment of Health Personnel. The change introduced a new way of defining what constitutes a country with a critical health worker shortage. The new calculations are based on a combined score of countries' health worker density per 1000 population and the Universal Health Coverage (UHC) service coverage index. It has led to an increase in the number of low- and middle-income countries (LMICs) considered at risk from active recruitment by high income countries (HICs). However, the 2021 WHO Safeguard list review failed to explicitly recognise the main causes of low health worker density in countries on the list. Many included countries are unable or unwilling to invest in their health sectors, which restricts the number of staff that can be hired. These countries experience high unemployment among trained and qualified health workers, despite their high need for health workers. Recent dramatic reductions in international aid and development support, means that LMICs that fail to invest in their health workforce, will face ever greater shortfalls in meeting the basic health needs of their populations. For WHO Safeguard-listed countries establishing bilateral health worker migration agreements, better support is needed to create fair deals that allow them to receive compensation from destination countries for the training costs of their emigrating health workers, which can be used to directly hire additional health workers back home.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distress Financing for Institutional Delivery in India: A Regional Analysis of Economic Inequality, Coping Mechanisms, and Contributing Factors","authors":"Puja Pal,&nbsp;Md. Juel Rana","doi":"10.1002/hpm.3950","DOIUrl":"10.1002/hpm.3950","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Financial hardship is among the significant challenges in the utilization of maternal healthcare services in India. It is further aggravated by the issue of inequality in the distress financing (DF) for institutional delivery (ID) which pushes the poor into a vicious cycle of poverty. The paper examines the pattern of inequality and regional variation in DF for ID in India. It also determines the factor contributing to the inequality in the DF for ID among a few selected states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The paper uses unit-level data from the fifth National Family Health Survey (NFHS-5) round conducted during 2019-21. The concentration curve (CC) and concentration index (CI) capture the inequalities in DF for ID. Also, the decomposition analysis of CI was performed to capture the contribution of key determinants in explaining the inequality in DF for ID.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study reveals that 16.3% of women in India incurred DF for ID, with the poorest quintile facing the highest burden (21.2%). Significant regional variations exist, with states like Telangana (30%) and Manipur (29.9%) showing the highest DF rates. Borrowing is the primary coping mechanism, particularly among the poorest. The concentration index (CI) analysis indicates that DF dominates among poorer women across states. Decomposition analysis highlights wealth status and education as the major contributors to inequality in DF, with significant regional disparities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Addressing DF for ID requires strengthening maternity benefit schemes like Janani Suraksha Yojana (JSY) to cover indirect costs and ensure timely disbursements while curbing informal charges. Reducing out-of-pocket expenditure (OOPE) through improving accessibility and quality of public hospitals and regulation of private facility fees is essential. Alongside, expanding health insurance for comprehensive maternity care is essential, particularly in high-inequality states like Telangana, Kerala, and Tamil Nadu. Promoting women's education and economic empowerment, could play a critical role in mitigating long-term disparities in healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 5","pages":"1151-1166"},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pandemic Agreement: What's Next?","authors":"Tiago Correia,&nbsp;Marine Buissonnière,&nbsp;Martin McKee","doi":"10.1002/hpm.70000","DOIUrl":"10.1002/hpm.70000","url":null,"abstract":"<p>The COVID-19 pandemic exposed critical weaknesses in global health governance, prompting the development of the WHO Pandemic Agreement, formally adopted by the World Health Assembly in May 2025. This landmark Agreement seeks to address the shortcomings of the 2005 International Health Regulations by establishing legally binding commitments to enhance pandemic preparedness, equity, and international solidarity. However, the negotiation process revealed deep geopolitical divisions, raising concerns about the Agreement's legitimacy and enforceability. Key provisions include improved surveillance, data sharing, protection for healthcare workers, and equitable access to medical countermeasures. Nevertheless, its effectiveness may be compromised by vague language, unresolved issues, and the absence or abstention of influential states. Implementation is further challenged by political fragmentation, sovereignty concerns, and disparities in national capacities. The Agreement's success will depend on sustained political will, robust accountability mechanisms, and meaningful national adoption. Ongoing debates over the definition of ‘pandemic’ and the WHO's limited enforcement powers underscore the tension between multilateral cooperation and national sovereignty. While the Agreement represents a significant step forward, it is not a panacea. Its promise lies in its potential to catalyse coordinated global action, but only if supported by genuine commitment and adaptive governance. As the world faces future health threats, the Pandemic Agreement must evolve into a practical tool for resilience, equity, and collective security.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 5","pages":"1029-1032"},"PeriodicalIF":1.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Collaboration Between Primary and Secondary Mental Healthcare via Boundary Spanning: Evaluation of a New Joined-Up Community Mental Healthcare Model in England","authors":"Lida Efstathopoulou,&nbsp;Jules Mackenzie,&nbsp;Rory Cameron,&nbsp;Adam P. Wagner,&nbsp;Julia Jones,&nbsp;Jesus Perez","doi":"10.1002/hpm.3949","DOIUrl":"10.1002/hpm.3949","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Community mental healthcare requires the collaboration of multiple services to meet the needs of local populations. Accessing mental health care in England often involves the collaboration of primary and secondary healthcare services. This paper presents the findings from an evaluation of ‘boundary spanning’ processes and practitioner roles aiming to reduce service fragmentation and improve access to mental healthcare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-one qualitative interviews with professionals across local healthcare providers were conducted in Peterborough (East England) to assess the impact of boundary spanning processes and practitioner roles and were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Structured boundary spanning processes and professional roles were found to facilitate communication and knowledge exchange between primary and secondary mental healthcare services, leading to optimisation of GPs' decisions about individuals' treatment pathways, and to improvements in service accessibility. Yet, effectiveness was reported as conditional on GPs' engagement, as well as the decentralised structure of primary care settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Community mental healthcare organisations could utilise boundary spanning interventions to flex organisational barriers between primary and mental healthcare and optimise accessibility of service users to mental health services. Boundary spanning processes and professional roles can be used to inform national and local care integration strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 5","pages":"1140-1150"},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3949","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Stakeholder Interests: A Balanced Scorecard Perspective on Performance Appraisal Implementation in China's Public Hospitals","authors":"Shufang Yao,&nbsp;Shaozhuang Ma,&nbsp;Lishuo Shi,&nbsp;Fang Wu,&nbsp;Elizabeth Reis","doi":"10.1002/hpm.3948","DOIUrl":"10.1002/hpm.3948","url":null,"abstract":"<div>\u0000 \u0000 <p>In 2019, the Chinese government initiated a National Performance Appraisal for Tertiary Public Hospitals (the ‘National Appraisal’), but limited study has been conducted on its appraisal indicators and its implementation effects. This study aims to assess how well this system balances the interests of key stakeholders in Chinese public hospitals and examines the positive changes and concurrent challenges it has brought to hospital operations. Utilising stakeholder theory and the balanced scorecard, we conducted two rounds of Delphi consultations with experts (<i>N</i>₁ = 46, <i>N</i>₂ = 29). We also analysed archival data from three hospitals' ‘National Appraisal’ records covering 2018 to 2020. Additionally, we conducted semi-structured interviews (<i>N</i> = 41) with key stakeholders from these hospitals. Kendall's coefficient of concordance was employed in both rounds to gauge the agreement among experts and thematic analysis was applied to analyse data from in-depth interviews with the key stakeholders of the three sampled hospitals. The results show that: (1) The key stakeholders of Chinese public hospitals include patients, hospital executives, health care workers, health authorities, and the public, but the ‘National Appraisal’ indicators only cover the first three stakeholders; (2) The ‘National Appraisal’ system adopted a balanced scorecard approach, patient-centre and with emphases on internal process; (3) The ‘National Appraisal’ had positive impacts on hospitals, clarifying hospital strategy and prioritising the public roles, enhancing health care quality, safety, and efficiency, as well as patient and health care worker satisfaction. However, implementation challenges arise from resource constraints, discrepancy between appraisal indicators and patient needs, misalignment between appraisal indicators and doctor's patient care practices, and the tension between nationwide standardized appraisal and local context. This study significantly contributes to the literature by empirically examining performance appraisal implementation in an under-researched country's public hospitals, offering practical implications and policy recommendations for practitioners, managers, and policymakers.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 5","pages":"1122-1139"},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}