INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE最新文献

Purpose: This paper analysed the impact and evolution of scientific research on the healthcare supply chain (HCS) from a longitudinal perspective, covering the period 1971-2024. The study used data from the Web of Science and Scopus databases to identify emerging and established areas of study in the field of HCS.

Design/methodology/approach: A bibliometric study was conducted using a dataset of 3,602 publications. The analysis focused on keyword co-occurrences to examine the evolution of HCS research. The representation of keywords is presented in tables, diagrams and longitudinal maps to highlight research topics in the field.

Findings: This study provides insights into the evolution of HCS research in terms of emerging and established areas of study. The analysis of 3,602 publications allowed the identification of key themes and trends in the field and offers a comprehensive view of the state of the art. The results are presented through tables, diagrams and longitudinal maps, thus facilitating a clearer understanding of the research landscape.

Practical implications: The findings have practical implications for researchers and scholars in the HSC domain. The identified research areas and trends provide valuable guidance for future research in the field. Researchers can use this information to navigate the current state of the field and make informed decisions about the direction of their research.

Originality/value: This study contributes to the understanding of the evolution of scientific research on healthcare supply chain from 1971 to 2024. By employing bibliometric analysis and visual representations, a unique perspective on the HCS landscape is presented. The results provide valuable insights for researchers and scholars, offering a foundation for further investigations in the field of HSC research.

Purpose: We aimed to assess the impact of plan-do-check-act (PDCA) cycles on tracheostomy weaning in ICU patients from 2019 through 2023.

Design/methodology/approach: A retrospective study was conducted at a private hospital, analyzing recorded data from two PDCA cycles that were implemented to reduce mean tracheostomy weaning times between 2019 and 2023. We further classified distinct timeframes for a separate analysis, including the baseline (April 2019-August 2020), the period post-PDCA cycle I (January 2021-April 2022) and the period post-PDCA cycle II (August 2022-December 2023).

Findings: A total of 70 individuals completed the protocol (mean age ± SD, 60.51 ± 17.19 years; 31.4% female). One-way ANOVA revealed mean differences in weaning time compared to 2019 were significant: 2020-3.86 days (p = 0.02), 2021-6.56 days (p = 0.00), 2022-7.80 days (p = 0.00) and 2023-8.74 days (p = 0.00). Subgroup analysis also revealed significant differences in weaning time among baseline, post-first PDCA cycle and post-second PDCA cycle (F (2) = 20.15, p = 0.00, η2 = 0.51).

Originality/value: This management model underscores the benefits of consistently improving the quality management of physiotherapy, delivering value-based healthcare through the collaboration of a multidisciplinary team.

Purpose: This study aimed to improve the efficiency and effectiveness of patient flow from the emergency department (ED) to the intensive care unit (ICU) in a super specialty hospital.

Design/methodology/approach: The study was conducted in the emergency department of a super-specialized hospital, focusing on inpatients requiring subsequent admission to the intensive care unit (ICU). It employed a cross-sectional observational design, utilizing primary data collected through first-hand observations via a data tracking sheet. Data analysis encompassed pre- and post-intervention phases, with 232 patients, including 108 patients in the pre-intervention phase and 124 patients in the post-intervention phase, to ensure statistically meaningful results. The study has also utilized tools such as Project Charter, Microsoft Excel, SIPOC, CTC and CTQ, DPMO, Six Sigma, Value Stream Mapping and Root Cause Analysis.

Findings: Reduced turnaround time (TAT) by 81%, increased value-added activity percentage from 24.4 to 37.2%, improved sigma level from 2.25 to 2.82 and decreased DPMO (defects per million opportunities) from 226,852 to 92,742.

Originality/value: This study focuses on a specific aspect of healthcare process improvement within a super-specialty hospital, employs a comprehensive Six Sigma methodology and statistical analysis to identify bottlenecks and improve efficiency, and focuses on TAT reduction and defect elimination.

Purpose: Oncology patients are a vulnerable group that faces multiple challenges, aggravated by long waiting times and service queues. This article aims to use Lean Six Sigma (LSS) to improve the chemotherapy preparation process and prospectively study the patient files' queue dynamics to prioritise process improvement remedies against adding resources strategy.

Design/methodology/approach: Six Sigma methodology has been employed together with Lean tools and queue dynamics in a case study research in a chemotherapy day unit to define, measure, analyse, improve and control the problematic process. The study population involved all internal customers and a sample of external customers (n = 450). The study processes were measured by 25 data points.

Findings: The most frequent problem was the "Long waiting time from oncologist assessment till receiving chemotherapy". Mean value-added time for chemotherapy preparation was 42 min, the defect was any patient's waiting time exceeding it. The average pre-intervention waiting time was 65.5 ± 27.20 min. The defect baseline sigma level was 0.78 sigma. Remedies involved assigning two pharmacists, arranging the pharmacy setting to satisfy chemotherapy preparation steps, adjusting the number of patients/hours, standardising patients' files interarrival time, delivering files to the pharmacy by piece, not by batch, and fixing the printers and landlines. Post-intervention mean patient waiting time was reduced significantly to 58.7 ± 23.44 min (p-value = 0.05), and the defect sigma level was raised to 0.91 sigma.

Research limitations/implications: This study draws attention to prioritising process improvement remedies in complex care settings with long queues.

Social implications: This study enhances service delivery and customer satisfaction.

Originality/value: This study serves as one of the few publications to study patient queue behaviour as a part of LSS improvements in healthcare projects.

Purpose: Achieving optimal health outcomes is central to global health policies. This study examines the impact of out-of-pocket (OOP) health expenditures and other determinants on life expectancy across income groups classified by the World Bank.

Design/methodology/approach: Using panel data and a fixed-effects model with dummy interactions, the findings reveal that OOP expenditures reduce life expectancy more in low-income economies, underscoring the need to lower financial barriers to healthcare.

Findings: Gross domestic product (GDP) per capita is significant for improving life expectancy more in low-income economies, but diminishing returns suggest aligning growth with health policies. Immunization consistently improves life expectancy, highlighting preventive care's importance. Unemployment limits healthcare access, particularly in low-middle-income economies, requiring policies to address economic instability. Alcohol consumption adversely affects life expectancy in high-income economies, highlighting the impact of lifestyle changes and the need for regulatory interventions.

Practical implications: By exploring the interplay of health expenditures, socioeconomic factors and lifestyle risks, the study offers insights for equitable global health policies aimed at improving health outcomes across income groups.

Originality/value: (1) While previous studies have analysed the impact of various socio-economic factors on life expectancy in developed economies, little is known about the impact of these factors in Low and Middle Income Economies. (2) Moreover, the impact of out-of-pocket health expenditure on life expectancy has not been comprehensively analysed across different income groups. (3) Findings reveal that out-of-pocket expenditures negatively affect life expectancy more in low-income economies than in high-income economies, emphasizing the need for reducing the financial burden to improve healthcare access. (4) Alcohol consumption adversely impacts life expectancy in high-income economies, highlighting the need for regulatory interventions targeting lifestyle-related risks. (5) This study enhances understanding of how health expenditures, socio-economic factors, and lifestyle choices influence life expectancy across income groups, offering insights to guide equitable global health policies.

Purpose: Employee participation in quality improvement is essential for fostering engagement and job satisfaction and delivering high-quality care, as highlighted in the total quality management literature. However, how employee participation is facilitated during quality improvement processes within healthcare organizations remains largely unexplored. Previous studies have identified a research gap, highlighting the importance of examining this phenomenon from the perspective of health professionals. The purpose of this study was to gain a deeper understanding of how health professionals in nursing homes experience their participation in quality improvement. The underlying aim was to describe their involvement and how it can be strengthened, ultimately improving the quality of care.

Design/methodology/approach: This study is based on interviews with 17 health professionals from 2 nursing homes in a medium-sized Swedish municipality. Data were analysed with Reflexive Thematic Analysis.

Findings: The themes identified through the analysis are "experiences of barriers at the organizational level that limit participation in quality improvement" and "experiences of barriers in daily care that limit participation in quality improvement".

Originality/value: The themes address barriers to participation in quality improvement, reflecting an organizational structure that hinders participation and quality improvement. A quality culture, along with structured approaches to improve quality and foster employee participation is lacking. Implementing total quality management could help address the challenges faced by health professionals in these settings.

Purpose: While many studies have addressed health communication and physician-patient interactions, knowledge about intercultural communication in medical tourism is limited. Our empirical study, therefore, investigates aspects related to patients' cultural beliefs regarding the quality of healthcare and the way this shapes their expectations and experiences in an intercultural medical interview setting at a Joint Commission International (JCI) accredited host country hospital in India. The theoretical foundation is the Communication Accommodation Theory.

Design/methodology/approach: A quantitative design was used in this study using the convenience sampling method. Data were collected from 300 medical tourism (MT) patients immediately after their face-to-face medical interview at the hospital.

Findings: The non-Western cultures displayed higher intercultural communication (ICC) expectations from the host country doctors than the Western patients, possibly on account of cultural similarity with and proximity to the host country. ICC beliefs of MT patients supported by convergent communication accommodation by the doctors led to the perception of better ICC experience in clinical consultations with the potential to improve word-of-mouth promotion, patient satisfaction and revisit intentions; patients' expectations mediated the relationship. Consultation time in minutes controlled the relationship between patient ICC beliefs, expectations and experience in the medical consultations. The proposed model was undifferentiated for age, gender and geography of the MT patient as well as wait time (in minutes).

Originality/value: While culture has been recognised as a significant factor in shaping the growth in medical tourism, research is scant on cultural and religious communication accommodation practices of host country doctors and medical staff and its effects on patient experience. Most studies on culture and MT have either evaluated the role of culture on the destination choice of international patients (cultural affinity or cultural familiarity) or have analysed the effect of distance between the host and the guest country as critical determinants of the choice of MT country. This study is probably the first to assess the quality of ICC beliefs, expectations and effects on MT patients' experiences. It is also the pioneering study to relate the context of MT with the well-regarded Communication Accommodation Theory, especially the manner in which convergent and divergent accommodation occurred between MT patients and MT service providers in the host country.

Purpose: This study aims to identify the barriers to accessing mental health services in Colombia, analyze the causes that generate them and how they perpetuate over time and critically call for the strengthening of the provision and guarantee of access to these services in the country.

Design/methodology/approach: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. The databases Science Direct, Proquest and Google Scholar were consulted, and the following search terms were used: Accessibility to health services, health disparities, bipolar disorder, schizophrenia and Colombia. A total of 35 articles meeting the inclusion criteria were analyzed, which allowed the classification of access barriers into five categories: governmental, personal, familial, social and institutional, all of which directly or indirectly affect access to mental health services.

Findings: Colombia regularly faces various social issues; thus, progress in the field of mental health in terms of treatment, research and prevention is imperative. For such a change to be possible, contributions from legislation and health authorities are required, taking into account the individuality of the patient, their context and their limitations.

Originality/value: This study offers a critical view of the barriers that hinder access to mental health services in Colombia, highlighting the need to strengthen the provision and guarantee access to these services.

Purpose: The study examines worldwide public health insurance and ageing studies. This was accomplished by doing a thorough bibliometric analysis of publications published between 2002 and 2022 (till 31st May), which includes 479 articles for the analysis.

Design/methodology/approach: This study used the Web of Science database to analyse the vast quantity of data from the journals referenced above. VOSviewer creates network maps, keyword concurrences and cross-country co-authorship. The research analyses parameters like article distribution by year and citation frequency to determine top publications. After that, co-authorship, country co-authorship and keyword co-occurrence bibliometric network maps are shown.

Findings: The finding of the study reveals that the year 2020 is the most productive year for publication; BMJ Open is referred to as the most productive journal in this area, and "Depression in the Elderly" is the most referenced paper. The US has published the highest number of articles. We've seen 21 authors work with "Akishita and Ishizaki". The USA is the most collaborative author with other countries and conducted a keywords-based cluster analysis in which "Public health insurance, older adults and long-term care" are the most frequent keywords in this domain.

Originality/value: This article aligns with the current literature on elderly public health insurance. The authors utilize bibliometric analysis to provide a more comprehensive and robust understanding of this area. Those interested in conducting further research in this field can use the findings of this study as a guide.

Purpose: From poor healthcare infrastructure to vaccine donors, India has traveled a long way. In this study, the author tried to find the investment certainty and persistence of volatility in the Indian healthcare system due to COVID-19.

Design/methodology/approach: Using the Generalized Autoregressive Conditional Heteroskedasticity (GARCH 1,1) model, this study quantifies the change in the conditional variance after the first case report of COVID-19. The author has used the S&P BSE HEALTHCARE index time series to analyze India's healthcare infrastructure and practices.

Findings: The author found evidence of a decrease in investment certainty in investments related to India's healthcare infrastructure and practices after the first case report of COVID-19. Furthermore, the estimation of the econometric model suggests the presence of a large degree of volatility persistence in the S&P BSE HEALTHCARE index.

Originality/value: This research would be the first of its kind where the return volatility of the Indian healthcare sector has been discussed. Also, this research quantifies the return volatility of the healthcare sector during the pre- and post-COVID-19 period.