{"title":"卫生商品综合采购制度对响应性与卫生服务提供关系的中介作用","authors":"Baraka Israel","doi":"10.1108/ijhg-03-2023-0028","DOIUrl":null,"url":null,"abstract":"PurposeThe problems that face health service delivery across different countries are compounded by financial, political, institutional and technical deficiencies. Yet, the role of technological aspects in the procurement of health commodities and health service delivery system requires in-depth exploration. This study bridges this gap by examining the mediating effect of an integrated health commodities procurement system on the relationship between responsiveness and health service delivery.Design/methodology/approachData for this study were collected from 274 respondents, comprising procurement staff and pharmacists using a cross-sectional questionnaire survey. A total of 28 government-owned hospitals from 6 regions in the Southern Highland of Tanzania were sampled for observation. Confirmatory factor analysis (CFA) and structural equation modelling (SEM) were used for data analysis.FindingsThe results of the study revealed a positive and significant relationship between responsiveness and integrated health commodities procurement system (β = 0.572, p < 0.001). Responsiveness positively and significantly affects health service delivery (β = 0.175, p = 0.004). The results also show that integrated health commodities procurement system is positive and significantly related to health service delivery (β = 0.264, p < 0.001). Lastly, the bootstrapping confidence intervals revealed that an integrated health commodities procurement system significantly mediates the relationship between responsiveness and health service delivery.Practical implicationsTo strengthen the health service delivery system, the study recommends enforcing internal control mechanisms and supporting policies that will monitor and evaluate the effectiveness of the integrated health commodities procurement system and service practitioners' responsiveness. Moreover, health service managers should ensure that the planning, procurement and distribution of health commodities are fully and effectively integrated at each node of the health supply chain.Originality/valueThe study contributes to the body of knowledge which examines the efficacy of health service delivery from procurement perspective. To the best of the author's knowledge, this is the first study that offers empirical evidence for the mediating effect of integrated health commodities procurement system on the link between responsiveness and health service delivery.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"Mediating effect of integrated health commodities procurement system on the relationship between responsiveness and health service delivery\",\"authors\":\"Baraka Israel\",\"doi\":\"10.1108/ijhg-03-2023-0028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"PurposeThe problems that face health service delivery across different countries are compounded by financial, political, institutional and technical deficiencies. Yet, the role of technological aspects in the procurement of health commodities and health service delivery system requires in-depth exploration. This study bridges this gap by examining the mediating effect of an integrated health commodities procurement system on the relationship between responsiveness and health service delivery.Design/methodology/approachData for this study were collected from 274 respondents, comprising procurement staff and pharmacists using a cross-sectional questionnaire survey. A total of 28 government-owned hospitals from 6 regions in the Southern Highland of Tanzania were sampled for observation. Confirmatory factor analysis (CFA) and structural equation modelling (SEM) were used for data analysis.FindingsThe results of the study revealed a positive and significant relationship between responsiveness and integrated health commodities procurement system (β = 0.572, p < 0.001). Responsiveness positively and significantly affects health service delivery (β = 0.175, p = 0.004). The results also show that integrated health commodities procurement system is positive and significantly related to health service delivery (β = 0.264, p < 0.001). Lastly, the bootstrapping confidence intervals revealed that an integrated health commodities procurement system significantly mediates the relationship between responsiveness and health service delivery.Practical implicationsTo strengthen the health service delivery system, the study recommends enforcing internal control mechanisms and supporting policies that will monitor and evaluate the effectiveness of the integrated health commodities procurement system and service practitioners' responsiveness. 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To the best of the author's knowledge, this is the first study that offers empirical evidence for the mediating effect of integrated health commodities procurement system on the link between responsiveness and health service delivery.\",\"PeriodicalId\":42859,\"journal\":{\"name\":\"International Journal of Health Governance\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2023-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Health Governance\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1108/ijhg-03-2023-0028\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Health Governance","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1108/ijhg-03-2023-0028","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 3
摘要
目的各国保健服务提供面临的问题因财政、政治、体制和技术方面的不足而更加复杂。然而,技术方面在卫生商品采购和卫生服务提供系统中的作用需要深入探讨。本研究通过检验综合卫生商品采购系统对响应性与卫生服务提供之间关系的中介作用,弥合了这一差距。设计/方法/方法本研究的数据收集自274名受访者,包括采购人员和药剂师,采用横断面问卷调查。对坦桑尼亚南部高地6个地区的28家政府所有医院进行了抽样观察。采用验证性因子分析(CFA)和结构方程模型(SEM)进行数据分析。研究结果显示,响应性与卫生商品综合采购制度之间存在显著正相关(β = 0.572, p < 0.001)。响应性对卫生服务提供有显著正向影响(β = 0.175, p = 0.004)。结果还显示,卫生商品综合采购制度与卫生服务提供呈显著正相关(β = 0.264, p < 0.001)。最后,自举置信区间显示,综合卫生商品采购系统显著调节响应性与卫生服务提供之间的关系。为了加强卫生服务提供系统,该研究建议实施内部控制机制和支持性政策,以监测和评估综合卫生商品采购系统的有效性和服务从业人员的响应能力。此外,卫生服务管理人员应确保卫生商品的规划、采购和分配在卫生供应链的每个节点得到充分和有效的整合。原创性/价值本研究对从采购角度考察卫生服务提供效力的知识体系作出了贡献。据作者所知,这是第一个为综合卫生商品采购系统对响应性与卫生服务提供之间的联系的中介作用提供经验证据的研究。
Mediating effect of integrated health commodities procurement system on the relationship between responsiveness and health service delivery
PurposeThe problems that face health service delivery across different countries are compounded by financial, political, institutional and technical deficiencies. Yet, the role of technological aspects in the procurement of health commodities and health service delivery system requires in-depth exploration. This study bridges this gap by examining the mediating effect of an integrated health commodities procurement system on the relationship between responsiveness and health service delivery.Design/methodology/approachData for this study were collected from 274 respondents, comprising procurement staff and pharmacists using a cross-sectional questionnaire survey. A total of 28 government-owned hospitals from 6 regions in the Southern Highland of Tanzania were sampled for observation. Confirmatory factor analysis (CFA) and structural equation modelling (SEM) were used for data analysis.FindingsThe results of the study revealed a positive and significant relationship between responsiveness and integrated health commodities procurement system (β = 0.572, p < 0.001). Responsiveness positively and significantly affects health service delivery (β = 0.175, p = 0.004). The results also show that integrated health commodities procurement system is positive and significantly related to health service delivery (β = 0.264, p < 0.001). Lastly, the bootstrapping confidence intervals revealed that an integrated health commodities procurement system significantly mediates the relationship between responsiveness and health service delivery.Practical implicationsTo strengthen the health service delivery system, the study recommends enforcing internal control mechanisms and supporting policies that will monitor and evaluate the effectiveness of the integrated health commodities procurement system and service practitioners' responsiveness. Moreover, health service managers should ensure that the planning, procurement and distribution of health commodities are fully and effectively integrated at each node of the health supply chain.Originality/valueThe study contributes to the body of knowledge which examines the efficacy of health service delivery from procurement perspective. To the best of the author's knowledge, this is the first study that offers empirical evidence for the mediating effect of integrated health commodities procurement system on the link between responsiveness and health service delivery.
期刊介绍:
International Journal of Health Governance (IJHG) is oriented to serve those at the policy and governance levels within government, healthcare systems or healthcare organizations. It bridges the academic, public and private sectors, presenting case studies, research papers, reviews and viewpoints to provide an understanding of health governance that is both practical and actionable for practitioners, managers and policy makers. Policy and governance to promote, maintain or restore health extends beyond the clinical care aspect alone.