Health Services Management Research最新文献

Previous studies of healthcare organizations' workforces and their performance have focused on burnout and its impact on care. The aim of this research is to expand on this and examine the association of positive organizational states, engagement and recommendation of employer as a place to work, in comparison to burnout on Hospital performance. Methods: This was a panel study of the respondents to the 2012-2019 yearly Staff Surveys of the English National Health Service (NHS) hospital Trusts with hospital performance measured by the adjusted inpatient Summary Hospital-level Mortality Indicator (SHMI). Results: In univariable regression, all three organizational states significantly and negatively correlated with SHMI, with recommendation and engagement showing a nonlinear effect. In multivariable analysis, all three states remained significant predictors of SHMI. Engagement and recommendation showed mutual correlation, with engagement being a more prevalent state than recommendation. Conclusion: Our study indicates that organizations could benefit from monitoring multiple workforce variables to preserve or enhance workforce well-being, while optimizing organizational performance. The surprising finding that higher burnout was associated with improved short-term performance requires further investigation, as does the finding of less frequent staff recommendation of work compared to staff engagement with their work.

Healthcare professionals' innovative work behavior (IWB) plays a key role in the development and implementation of innovative solutions in hospitals. However, relevant antecedents of IWB have not been fully captured to date. This study empirically examines the relationships between proactive personality, collaborative competence, innovation climate, and IWB. Hypotheses were tested using a sample of 442 chief physicians from 380 German hospitals. The results indicate a positive and significant influence of proactive personality, collaborative competence, and innovation climate on IWB, with collaborative competence having a stronger influence on IWB than innovation climate. Managers should note that important resources for IWB are accessible through a variety of actors and relationships. To leverage these resources and thus promote IWB, more emphasis should be placed on an employee's network.

This study aimed to use national data to examine the relationship between staff and inpatient survey results (National Health Service (NHS) Friends and Family Test (FFT)) and assess how these align with more traditional measurements of hospital quality as captured by the summary hospital mortality indicator (SHMI). Provider level FFT responses were obtained for 128 English non-specialist acute providers for staff and inpatients between April 2016 and March 2019. Multilevel linear regression models assessed the relationship between staff and patient FFT recommendations, and separately how SHMI related to each of staff and patient FFT recommendations. A total of 1,536 observations were recorded across all providers and financial quarters. Patients were more likely to recommend their provider (95.5%) than staff (76.8%). In multivariable regression, a statistically significant association was observed between staff and patient FFT recommendations. A statistically significant negative relationship was also observed between staff FFT recommendations and SHMI. The association between SHMI and staff FFT recommendations suggests that staff feedback tools may provide a useful analogue for providers in potential need of intervention and improvement in care. For patients meanwhile, qualitative approaches and hospital organisations working in partnership with patients may provide better opportunities for patients to drive improvement.

Objectives: Developing a valid tool to measure perceived social responsibility (SR) practices towards employees and examining the impact of employee-centered SR considerations on the employees' job satisfaction.

Methods: A cross sectional survey of employees at three private hospitals was conducted. Data was collected using a self-administered questionnaire. It consists of baseline characteristics, structured SR measuring scale, job satisfaction questionnaire and Perception of Empowerment Instrument (PEI).

Results: The questionnaire developed to measure SR towards employees showed excellent internal consistency reliability (Cronbach's alpha is > 0.7). A considerable number of SR criteria were perceived as partially or fully met by the majority of studied employees except for rewarding, training activities, salary satisfaction and enhancement activities. Significant correlation was found between employees' job satisfaction and all domains of SR as well as employees' empowerment. Multiple linear regression analysis showed that significant predictors of employee's satisfaction are fulfillment of economic and social responsibility criteria as well as the level of perceived empowerment.

Conclusions: In healthcare industry in Egypt, fulfillment of the basis for SR is one of the predictors of achieving high job satisfaction. Extra-performance rewarding and career development should be looked at while managing human resources.

Bureaucratic and administrative tasks associated with health care provision have historically fallen on health care professionals, which is one among the factors contributing to low job satisfaction and lower productivity. Incorporating new professional roles that help to better respond to the needs of both patients and professionals can increase the quality and efficiency of service provision. This article aims to evaluate the impact of the clinical assistant's introduction in the Sant Joan de Déu Barcelona Children's Hospital's pediatric oncology department, in terms of (i) displacement of activity loads carried out by this new professional role and the consequent time freed up for physicians, (ii) physicians' satisfaction and (iii) efficiency of the new care model. This is an observational and retrospective study using administrative data based on the type of activity performed by clinical assistants and the measurement of the time freed up in favor of the physicians. The potential skill mix productivity increase, survey of physicians' satisfaction, and reduction in costs with the new model was analyzed. During the first year of its implementation in the pediatric oncology department, clinical assistants have performed 13,553 requests (69% of the total), representing a total saving of 266.83 hours or 6.67 workweeks of 40 hours. They performed 74% of outpatient surgical requests in the oncology department, 87% of day hospital requests and 54% of total requests in the outpatient consultations area. Physicians are overall satisfied with the new role and think they can use the time gained to do other things such as research or improving the quality of care. The role change allows reducing the cost per request by 56% in relation to the conventional model. In conclusion, the introduction of clinical assistants in the oncology department could be efficient to the extent that it displaces a significant part of the bureaucratic and administrative tasks previously performed by health care professionals and thus enables to reduce the cost of these processes. This delegation allows them to work more closely to the maximum of their competences and the physicians to have more time for higher added value clinical tasks and increase professional satisfaction.

Turnover among nurses has been recognized as a frequent and enduring problem in healthcare worldwide. The widespread nursing shortage has reached the level of a healthcare crisis. The COVID-19 pandemic has illustrated the importance of understanding the contributing factors of nurse turnover, and more importantly how to mitigate the problem. Using cross-sectional survey data collected from 3370 newly licensed nurses working across 51 metropolitan areas within 35 U.S. states, we explore how role overload and work constraints can both diminish job satisfaction and increase turnover intentions of new nurses. Coworker support and work role centrality are identified as moderators of these relationships which show potential to mitigate these negative outcomes. This study highlights the importance of coworker support and work centrality in improving job satisfaction and subsequent turnover intentions among newly licensed nurses.

Background: There is growing evidence of the relevance of designing organization of care around patient characteristics; this is especially true in the case of complex chronic diseases.Purpose: The goal of the paper - that focuses on the analysis of the clinical condition hemophilia in three different centers - is to address two different research questions:1. How can we define, within the same clinical condition, different patient profiles homogeneous in terms of intensity of service required (e.g. number of visits or diagnostics)? 2. What are the conditions to re-organize care around these patient profiles in a multidisciplinary and coordinated manner?Research design: The authors have used a multiple case study approach combining both qualitative and quantitative methodologies; in particularly the semi-structured interviews and the direct observation were aimed to map the process in order to come up with an estimate of the cost of the full cycle of care.Study sample: The research methodology has been applied consistently in three different centers. The selection of the structures has been based on two main different criteria: (i) high standards regarding both organizational and clinical aspects and (ii) willingness from management, nurses and physicians to provide data.Results: The study clearly shows that different patient profiles - within the same clinical condition - trigger a different set of diagnostic and therapeutic activities. It is, thus, important considering patient characteristics in the development and implementation of clinical pathways and this will imply relevant differences in terms of organizational and economic impact.Conclusions: These process-based analyses are very much critical especially if we want to move to a bundled and integrated payment system but, as shown by this study itself, require a lot of time and efforts since our healthcare information systems are still fragmented and vertically designed.

Life expectancy, quality of life and satisfaction of oncologic patients highly depend on access to adequate specialized services, that consider their conditions in a holistic way. The present study aims to evaluate the introduction of oncology services in an outpatient setting in a mountain village in Northern Italy. The initiative is evaluated using the three pillars of sustainability (social, economic and environmental) as dimensions that are often overlooked by healthcare policy makers. Using micro data on 18,625 interventions, we estimate the number of kilometers saved by patients (reduction of "travel burden" as indicator of social sustainability), the additional travel costs for the NHS (indicator of economic sustainability) and the implied reduction of CO₂ emissions (indicator of environmental sustainability). Over the period July 2016-2021, the decentralized health center delivered 2,292 interventions saving 218,566 km for a corresponding value of €131,140. The additional costs for the NHS was €26,152. The reduction of CO₂ emissions was 32.37 Tons (€5,989). Overall, the socio-economic benefit of reducing travel of care for the patients residing in this remote valley was €110,976. This study adds original understanding of the benefits of decentralizing oncologic care and shows its operational feasibility conditions. Given the modest number of similar projects, it provides evidence to policy makers and, especially, managers who are faced with the challenge to implement the decentralization of specialized services.

Background: in the field of rare diseases (RDs) most of the European studies on budget impact analysis of drugs that have been conducted often lay on theoretical assumptions and focus only on Orphan drugs (ODs). Objectives: we aimed to estimate the budget impact of specific drugs for non-oncological RDs, both ODs and non-ODs, using real-world data about patients residing in Veneto Region (Italy) and to describe its expenditure structure and dynamics. Methods: a population-based multi-source observational study was conducted using data from Regional administrative databases; an ad-hoc drugs' list specific for RDs including both ODs and non-ODs and classifying them by ATC codes has been created. Results: In 2019, the total expenditure for drugs specific for RDs was EUR 97.2 million (6.6% of the total Regional budget). The RD drug list included 58 ATC codes, of which 15 ATC had an annual budget impact over EUR 1 million ("blockbuster drugs"). The most expensive treatment was a non-OD drug (Coagulation factor VIII). The two most represented therapeutical areas were the metabolic and the hematological ones. Conclusions: Cost analyses on RD high-cost drugs expenditure should consider any specific RD drug, not only ODs. Expenditure dynamics for RD drugs are peculiar showing "blockbuster drugs". Some therapeutical areas seem to be lacking in the drug research field.

This study was conducted to determine the variables that play a role in the efficiency of Health Management departments in Turkey and the ranking of them in order of importance. These variables were determined by systematic analysis. The Prisma method was used in the systematic analysis approach. Input and output variables used in studies assessing the efficiency of higher education institutions in the literature were listed. The ranking of these variables was determined by Analytical Hierarchy Process (AHP) method. The questionnaire used for the AHP analysis and the judgments of 127 academicians working in Health Management Departments in universities in Turkey were assessed. The first three input variables found as a result of the AHP were "the number of registered undergraduate students per faculty member", "the number of faculty members", and "the number of other academic staff". The most important three output variables included "the number of articles searched on SCI, SSCI, SCI-E", "the number of papers presented in international congresses", and "the count of publications published in international peer-reviewed journals". To achieve positive developments in the efficiency of Health Management Departments, it is recommended to carry out studies to increase the number of qualified publications.