Journal of Health Organization and Management最新文献

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: This study examines work ability, defined as the balance between personal resources and job demands. It is considered a key indicator of sustainable employability, a critical issue in the healthcare context. Specifically, it analyzes how job resources and demands shape employees' work ability and evaluates the role of work-life balance as a potential mediator of these relationships.

Design/methodology/approach: We estimate structural equation modeling (SEM) using STATA 18 on a sample of 443 healthcare workers at the University Hospital of Modena (Italy).

Findings: Our findings show that supportive supervisors, work autonomy and discretion positively influence work ability. Work-life balance emerges as a crucial mediator of the relationships between work autonomy, work intensification and employee work ability.

Practical implications: These results underscore the crucial role of organizational practices in bolstering work ability and well-being. Key priorities include enhancing leadership quality through training and mentoring initiatives. Equally important is fostering work-life balance by enhancing employee autonomy and involvement in key decisions related to their work.

Originality/value: This paper contributes to the literature by providing an in-depth analysis of job demands and resources affecting work ability in the healthcare sector. Furthermore, it is the first study to evaluate the mediating role of work-life balance in this specific context.

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: The conclusion of the COVID-19 pandemic provides an opportune moment to assess the performance of health systems in financial protection. This study aims to analyze the state of financial protection within Iran's healthcare system during the COVID-19 pandemic and propose practical solutions to enhance the system's financial protection.

Design/methodology/approach: This study, conducted in three stages, first assessed financial protection among 24,170 COVID-19 patients in three major Tehran hospitals, categorized by insurance status. We used dispersion indices to depict cost distribution and the Kruskal-Wallis test to analyze variations in out-of-pocket payments. In the second phase, ordinary least squares regression identified key factors affecting out-of-pocket payments. The third stage involved deriving strategies to improve health system financial protection using the Delphi technique and prioritizing them with the TOPSIS approach.

Findings: The average patient hospitalization cost was 512.41 US$, with patients covering 29.60% of total expenses while insurers handled 70.39%. Among Iran's basic health insurances, armed forces insurance exhibited the highest financial protection, with over 90% for insurers and less than 10% for the insured. The study highlights the significance of factors like prevention, equitable access, healthcare cost structuring and economic efficiency in enhancing financial protection. Priority for strengthening financial protection is given to promoting disease prevention and structuring demand through family doctor mechanisms and referral systems.

Originality/value: Enhancing financial protection requires attention to a wide range of measures, including health promotion and prevention, organizing healthcare demand, improving access structures, leveraging technological advancements and optimizing economic efficiency within the healthcare system.

Purpose: The aim of this study is to describe the application of the Learning from Excellence (LfE) approach in supporting a learning-oriented use of performance measures and continuous quality improvement in breast cancer (BC) care.

Design/methodology/approach: Using a mix-method research, the BC pathway is evaluated among 12 Italian regions/autonomous provinces sharing the same Performance Measurement System. The study was conducted in three stages: (1) identification of the best performing geographical areas through quantitative evidence; (2) analysis of the best practices with qualitative methods; (3) professional engagement and quality improvement, and involvement of stakeholders.

Findings: In the quantitative phase, the performances of 50 geographical areas were analyzed, leading to the identification of two best performing areas. After the characterization of the organizational determinants featuring the best performers' practices, the professionals were involved through on-site workshops, implementing a learning-oriented use of performance measures, benchmarking and team reflexivity on performance results. The intervention implied the modelling and assessment of the best performers' pathways, complementing performance measures with experience-based information. The models of the two areas were compared and hypothesis of care improvement were discussed. Feedback, reflexivity, networking and culture reinforcement were enacted among all the network professionals. In the last stage, the results were publicly presented allowing all stakeholders to recognize and appreciate the collaborative effort produced for the care of BC women and, leveraging on the logic of benchmarking, the stakeholders where able to identify generable performance improvements.

Originality/value: This study provides evidence about the potential benefits of implementing LfE as a total quality management practice for care pathways.

Purpose: This study utilizes the extended technology acceptance model (E-TAM) to explore the key factors influencing the behavioral intention of Generation X (Gen X) users in Malaysia to adopt mobile health applications (MHAs).

Design/methodology/approach: A total of 252 responses were gathered from the Malaysian Gen X population through an online survey using a non-probability purposive sampling technique. Data were analyzed using SmartPLS software to validate the proposed framework and provide a logical foundation for achieving the study's objectives.

Findings: The results reveal that perceived system quality (PSQ), perceived mobile experience (PXS), perceived ease of use (PEOU), perceived playfulness (PPF), perceived usefulness (PU) and attitude are all positively associated with behavioral intention to use MHAs.

Originality/value: This research extends the TAM by introducing novel constructs - PSQ, PXS and PPF - forming the E-TAM framework to analyze MHA adoption, a perspective not previously explored in the Malaysian context. From a practical standpoint, this study provides actionable insights to enhance the adoption of MHAs among Malaysia's pivotal Gen X population. The findings aim to guide the development of engaging and user-friendly mHealth applications to improve self-care capabilities and increase user satisfaction.

Purpose: This study aims to first investigate and compare the perceptions of departed and on-the-job nurses in the patient safety culture and then identify critical dimension(s) that might affect these two groups.

Design/methodology/approach: A chi-squared test is employed to find critical demographic variables between departed and on-the-job nurses. In addition, linear regression with forward selection is used to identify the essential dimensions of the Chinese version of the Safety Attitudes Questionnaire (CSAQ) that affect the overall satisfaction of the patient safety culture in a regional teaching hospital in Taiwan. A total of 196 departed nurses and 386 on-the-job nurses participate in this study.

Findings: No significant differences in eight dimensions along with the overall satisfaction of the patient safety culture are found between these two groups. For departed nurses, the strongest predictor of the overall satisfaction of the patient safety culture is perceptions of management, while safety climate and teamwork climate have significant relationships with the overall satisfaction. On the other hand, working conditions is the most essential dimension influencing the overall satisfaction from on-the-job nurses' viewpoints followed by perceptions of management and emotional exhaustion. The perceptions of management are the only factor that influences the overall satisfaction for both groups.

Practical implications: Measuring the patient safety culture cannot predict nurses' turnover; however, some aspects of dimensions from the CSAQ are associated with the overall satisfaction of the patient safety culture.

Originality/value: Health practitioners should focus on implementing known strategies to improve the overall satisfaction, including support from leadership, sufficient resources and burnout alleviation.

Purpose: These days, supply chain management (SCM) is essential to maintaining the long-term sustainability of the whole manufacturing ecosystem. This research examines the effects of competitive priorities (cost, quality, flexibility and delivery) on achieving success for the three key participants in SCM: suppliers, distributors and customers.

Design/methodology/approach: Survey data from 258 workers in pharmaceutical businesses was utilized in an empirical study partial least squares structural equation modeling (PLS-SEM) was employed to examine whether supply chain capabilities (SCC) were influenced by competitive advantage (cost, quality, flexibility and delivery).

Findings: The results of the investigation show a favorable correlation between competitive advantage in the Ethiopian pharmaceutical and medical supplier industry and SCC.

Originality/value: This study demonstrates the positive impacts of cost, quality, flexibility and delivery on suppliers, distributors and customers. Our findings suggest that pharmaceutical and medical suppliers prioritize achieving high-quality service before focusing on cost reduction.

Purpose: Although the doctor-patient relationship (DPR) in China has improved during the COVID-19 pandemic, conflicts still persist, especially in high-pressure environments like emergency departments (EDs). Previous research has not explored how media portrayal of healthcare professionals impacts this relationship in emergency settings. This study aims to analyze the correlation between media representation of healthcare professionals and DPR in Chinese EDs, with the goal of identifying strategies to improve patient satisfaction, enhance trust and promote effective medical outcomes.

Design/methodology/approach: This cross-sectional study was conducted across 40 hospitals in 8 provinces in China. Using a self-designed electronic questionnaire, data were collected from healthcare professionals. Multiple linear regression models were employed to analyze the correlation between the DPR and the portrayal of healthcare professionals by the media in ED.

Findings: The results indicated a higher rate of verbal and physical conflicts in EDs, suggesting a tense DPR. The positive portrayal of healthcare professionals by the media is positively correlated with DPR and doctor-patient trust. Furthermore, the positive portrayal of healthcare professionals by the media is negatively correlated with the frequency of physical conflicts.

Originality/value: The study highlights the media's critical role in shaping public perceptions that impact DPRs, especially in high-stress settings. A comprehensive multi-stakeholder approach is recommended, involving media self-regulation, government policy, healthcare organization initiatives and empowered healthcare professionals. By strategically managing the media's influence through this coordinated approach, the findings can drive enhanced trust, improved patient satisfaction and more effective medical outcomes.

Purpose: This study investigates how realized affordances of mobile health technologies influence the relationship between technology use, patient empowerment and well-being in diabetes self-management.

Design/methodology/approach: The research proposes a technology use-empowerment-well-being (TEW) model based on affordance theory. Data were collected through a survey of 257 diabetes patients using mobile technologies for self-management and analyzed using structural equation modeling with SmartPLS.

Findings: Results indicate that patient empowerment fully mediates the relationship between mobile technology use and patient well-being. Importantly, realized affordances moderately strengthen the relationship between technology use and patient empowerment, demonstrating that patients derive greater benefits when they actively utilize technology's capabilities for diabetes management.

Research limitations/implications: Reliance on self-reported data and the cross-sectional design limit causal inferences about the evolution of technology-empowerment-well-being relationships over time.

Practical implications: Healthcare technology designers should focus on creating clear, tangible benefits for patients that support specific self-management behaviors. Healthcare providers should educate patients about the benefits of technology and support them in realizing these affordances through training and ongoing assistance.

Originality/value: This study integrates affordance theory with patient empowerment concepts, providing empirical evidence that realized affordances - not merely technology availability - are critical for improving self-management outcomes. The TEW model introduces a novel framework for understanding how technology empowers patients and enhances well-being in chronic disease management.