Journal of Health Organization and Management最新文献

Purpose: Healthcare has been facing rising challenges in recent years. To mitigate these issues, an appreciable amount of effort has been invested in studies about Healthcare 4.0. Despite the recognized importance of this topic, its recentness and multidisciplinary character are obstacles to its precise understanding. In this light, this paper aims to provide a comprehensive view of the current development of Healthcare 4.0.

Design/methodology/approach: We systematically reviewed the literature, which resulted in 130 papers retrieved from the Web of Science and Scopus databases. Quantitative and qualitative analyses were carried out using this sample.

Findings: As a result of the quantitative analysis, we notice an increasing trend in health-related studies, notwithstanding its novelty. India is also recognized as the leading reference on the subject, as it is the country with more papers in the sample and the most influential authors. On the other hand, through qualitative analysis, an extensive review and analysis of the technologies and applications of Healthcare 4.0 is presented, along with a discussion of its underexplored areas.

Originality/value: The results of this paper provide valuable knowledge to guide and encourage further analysis on this topic, including recommendations for future research directions.

Purpose: This study aims to evaluate the effects of perceived leader--member exchange and working conditions on turnover intention among healthcare employees.

Design/methodology/approach: The study population consisted of healthcare employees working in a medical faculty hospital in Türkiye. A stratified sampling method was used in sample selection. The data were obtained by the questionnaire method, and voluntary participation was taken as a basis. The questionnaire included sociodemographic information, a leader--member exchange (LMX) scale and a turnover intention scale. The research was conducted between April and May 2022 and completed with 400 participants. Descriptive statistics, correlation analysis and multiple linear stepwise regression analyses were chosen for data analysis.

Findings: The findings showed that the participants had a medium-level perception of leader--member exchange and a medium-level turnover intention. Multiple linear stepwise regression analysis revealed that especially "affect and professional respect" sub-dimensions of LMX had a statistically significant and negative effect on turnover intention scores. In addition, weekly working hours had a statistically significant and positive effect on turnover intention (p < 0.05). Finally, it was determined that the variance in turnover intention score was explained by the "affect and professional respect" sub-dimensions of LMX and weekly working hours (R² = 0.241).

Originality/value: This study provides evidence on the impact of the "affect" and "professional respect" sub-dimensions of leader-member exchange as well as work environment factors on the turnover intentions of healthcare employees. The results are expected to guide healthcare organization leaders and managers on how to create a collaborative work environment that leads to employee retention.

Purpose: The objective of this paper is to investigate how top managers in public healthcare interpret and perceive their autonomy within a highly centralized system and how their roles and attitudes have evolved in response to centralization.

Design/methodology/approach: The research examines how increased centralization and reduced organizational autonomy affect decision-making in hospitals, employing qualitative analysis through in-depth interviews with top managers. The study collected and analyzed data from 15 hospital managers in year 2015 and 2022 (eight interviews each year, one person interviewed twice), to capture changes following significant centralization efforts and the effects of the pandemic and health sector reforms.

Findings: Centralization has reduced financial and operational managerial autonomy for many institutions, leading to delays in decision-making, especially in financial matters and has also brought significant administrative and reporting burdens. Despite this, hospital managers reported retaining some professional autonomy in developing and managing their service portfolios, but this autonomy is primarily operational rather than strategic and is limited by financial constraints.

Research limitations/implications: This study examines the Hungarian healthcare system, influenced by unique political context, which also presents a methodological limitation concerning the transferability of findings.

Practical implications: Hospital top managers' professional autonomy is often obscured by heavy administrative and financial pressures; thus, enhancing their strategic mindset is essential.

Social implications: Policymakers should adopt a comprehensive perspective in hospital maintaining, with a particular focus on balancing financial and medical perspectives.

Originality/value: The paper focuses on an under-explored area: the organizational autonomy of hospital top management in the context of centralization efforts, delivering a message to both hospital managers and policymakers by emphasizing organizational aspects.

Purpose: This study examines the efficiency dynamics of public health service providers in Colombia between 2010 and 2021. In order to achieve this objective, a data panel is utilized to assess the effectiveness of 841 institutions across three levels of complexity (1, 2 and 3) in providing patient care, taking into account user satisfaction from 2010 to 2021.

Design/methodology/approach: By employing growth mixture analysis (GMA) and other statistical techniques, we may identify unique efficiency profiles among hospitals with different levels of complexity.

Findings: The results demonstrate varied efficiency patterns, with certain profiles generally retaining or improving efficiency over time, while others observe fluctuations or reductions. Efficiency outcomes are significantly impacted by factors such as capital investment, operational costs and workforce mix. Efficiency levels can be improved by making strategic investments in capital infrastructure and implementing effective operational cost management.

Originality/value: Changes in the healthcare market conditions in recent years in Colombia have compelled healthcare providers (IPS) to transform themselves into sustainable organizations.

Purpose: Publicly funded healthcare systems struggle to govern and determine how finite resources should be allocated in relation to political goals within a pre-determined budget. Primary healthcare (PHC) has a central multipurpose function, not least in terms of political strategies, but PHC governance is still largely underexplored. The aim is to explore how politicians responsible for making decisions pertaining to healthcare coverage navigate the governance of public PHC and disentangle it in the form of narratives based on different types of underlying rationales.

Design/methodology/approach: Semi-structured interviews were conducted with 15 politicians from 3 Swedish regional healthcare authorities. The data were analysed abductively based on scientific, clinical and cultural rationales using thematic content analysis.

Findings: Our study provides insights into how PHC's multipurpose function implicates tensions between politicians' different responsibilities regarding healthcare coverage. It shows how politicians navigate various coexisting rationales, with some being more dominant than others and where tensions also exist between them. In this balancing act, they create narratives addressing different stakeholders and priority-setting dilemmas, reflecting the diverse rationales. Our study reveals that politicians play a crucial role in PHC governance and priorities, balancing rationales that might otherwise become overly dominant.

Originality/value: This paper contributes new knowledge by displaying how politicians balance tensions within and between rationales through different narratives regarding goals/commissions, problematic situations and preferred solutions in PHC governance.

Purpose: With the pandemic reshaping healthcare delivery, telemedicine has emerged as a vital solution for overcoming access barriers, particularly in resource-constrained settings. Hence, this study explores the key drivers behind the sustained use of telemedicine services in low-income countries during the post-pandemic period.

Design/methodology/approach: Using a quantitative research approach and purposive sampling technique, 273 valid responses were gathered from participants in Bangladesh. A comparative analysis utilizing partial least squares structural equation modeling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) were conducted to ensure greater accuracy.

Findings: The PLS-SEM analysis revealed that expectation confirmation and perceived ease of use positively influence satisfaction. Similarly, perceived usefulness and perceived ease of use directly impact Attitude toward telemedicine services. However, perceived usefulness and perceived security were not significantly associated with satisfaction and attitude toward telemedicine services, respectively. The findings highlight that user satisfaction drives continuance use intention for telemedicine services, but only when it also cultivates a positive attitude toward telemedicine services. While the PLS-SEM findings indicate that perceived usefulness has no significant relationship with satisfaction and perceived security is not significantly associated with attitude toward telemedicine services, the fsQCA results offer a different perspective. fsQCA reveals that perceived usefulness retains a significant association with satisfaction and that perceived security, regardless of whether its effect is high or low, is equally effective in contributing to the intention for continuous telemedicine use. These findings underscore fsQCA's ability to provide deeper insights into the complex causal relationships among the antecedents.

Practical implications: The findings provide valuable insights for hospitals, doctors and telemedicine providers on retaining existing users. Additionally, governments can leverage this information to address healthcare disparities between urban and rural areas. The study also identifies strategies to reduce costs and improve the efficiency of healthcare services.

Originality/value: This study advances telemedicine research by employing the extended technology continuance theory (ETCT) alongside a hybrid analytical approach that integrates PLS-SEM and fsQCA. It highlights that telemedicine organizations can boost patient confidence and encourage continued use by enhancing satisfaction and cultivating a positive user attitude. The innovative use of ETCT and the combined methodologies provide a comprehensive analysis, offering actionable strategies to retain telemedicine users in low-income countries during the post-pandemic period.

Purpose: The study aims to explore how healthcare workers (HCWs) navigate and experience time when caring for older cancer patients living with other illnesses.

Design/methodology/approach: This paper presents findings from a qualitative study of how HCWs conceptualise and navigate the temporal aspects of delivering personalised care to older people living with multimorbidity. Building on research from organisation studies and the sociology of time, we interviewed 19 UK HCWs about their experiences of delivering care to this patient group.

Findings: Our findings illustrate how the delivery of personalised care contradicts contemporary models for healthcare delivery defined by efficiency and standardisation. We found that HCWs engage with time as both a valuable commodity to be rationed and prioritised within a constrained context and as a malleable resource for managing workload and overcoming "turbulence" in the system. However, participants in this study also shared how the simultaneous multiplicity and lack of time had a profoundly personal impact on them through the emotional toll associated with "time debt" and "lost" time.

Originality/value: This research presents a unique analysis of how time is conceptualised and navigated in contemporary healthcare, offering valuable insights for policy improvement. We conclude that personalised models of healthcare are incompatible with many current temporal structures of treatment trajectories and work-practices, by nature of being centred around the person and not the system of delivery.

Purpose: Healthcare organizations are rethinking their practices in response to the framework provided by the sustainable development goals (SDGs). The purpose of this paper is to explore whether, how and why sustainable development practices have been implemented in the healthcare sector.

Design/methodology/approach: The study is based on a systematic literature review, carried out using Scopus and Web of Science databases. The papers were analyzed according to the five activity-based theoretical framework categories: purpose, subject, community, object and practices.

Findings: Results reveal a lack of research regarding the integration of sustainable development and SDGs into managerial systems or functions. Moreover, they identify key areas of interest within sustainable development and healthcare practices, offering guidance for future research and strategies to better align healthcare with the SDGs.

Originality/value: To the best of the authors' knowledge, this is the first paper that aims to summarize the scientific literature on this topic through the lens of the activity-based theoretical framework, allowing for an analysis of the literature that investigates how sustainable development practices shape organizational life.

Purpose: The purpose of this study is to explore the mediation of organizational identification (OI) in the relationship between employees' psychological capital (PsyCap) and their engagement in organizational-oriented citizenship behaviors (OCBO). We examine the proposed theoretical model through the lens of the job demand and resources (JD-R) model and social identity theory (SIT), focusing specifically on the healthcare setting.

Design/methodology/approach: Employing a structured questionnaire, responses were collected from 240 healthcare professionals working in multinational pharmacovigilance firms in select Tier-I Indian cities using purposive sampling. Model testing constituted performing statistical analyses using partial least squares-structural equation modelling (PLS-SEM) in the R environment, an open-source software.

Findings: Results revealed a significant positive association between PsyCap and OCBO. In addition, we found that OI mediated the relationship between PsyCap and OCBO. This suggests that practitioners can stimulate extra-role performance in employees through enhancing PsyCap and fostering psychological oneness with the organization.

Research limitations/implications: The research emphasizes the significant role of employees' personal resources, manifested in the form of PsyCap, in having a bearing on their attitudes and feelings towards the organization. We explore the under-researched latent mechanism of the PsyCap and OCBO relationship through employees' social identification process.

Originality/value: In this research, we uncover the underlying mechanism of PsyCap and OCBO association by highlighting the latent role of OI on a unique set of healthcare professionals.