Health care as a worldwide concern. Insights on the Italian and Indian health care systems and PPPs from a VSA perspective

2014 ◽  
Vol 9 (2) ◽  
pp. 198-220 ◽  
Author(s):  
Marialuisa Saviano ◽  
Ratri Parida ◽  
Francesco Caputo ◽  
Saroj Kumar Datta

Purpose – Health is a fundamental populations’ need and an integral part of the socio-economic development of a country. However, it is required to explain the growing role of the private sectors in addressing various health care needs. The purpose of this paper is to analyse potential contribution, criticalities and conditions of success of public-private partnership (PPP) as a strategy to face the complexity of nationally relevant Italian and Indian service systems. Design/methodology/approach – The methodology is built upon the basis of the viable systems approach (VSA) integrated with the fundamental interpretative elements of service science and service-dominant logic to contextualize interpretation to the management of service systems benefitting from recent advances in these research fields. Findings – A VSA-based general framework of reference is built that is useful for analysing any relational context in which different aims and expectations need to be harmonized to make the collaboration effective. On the basis of this framework, first insights on Italian and Indian health care PPPs are proposed, highlighting key elements of analysis and criticalities that may challenge a positive conclusion on health care PPPs. Practical implications – The implications of the study are both theoretical and practical. From a theoretical perspective, the study contributes to the scholarly understanding of complex health care system in Italy as well as in India with particular reference to the public-private collaboration phenomenon. It also suggests theoretical approaches in the form of a generic VSA-based framework as applicable. From a practical perspective, the study stimulates managers to a critical reflection about current health care management approaches which are reflected in the adoption of PPPs solutions. Originality/value – The paper discusses relevant worldwide decision-making challenges, such as the equality in the populations’ access to health service, suggesting managers the way to create conditions of consonance among the diverse stakeholders for a successful health care PPPs.

2013 ◽  
Vol 5 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Sawsan Abdel-Razig ◽  
Hatem Alameri

Abstract Many nations are struggling with the design, implementation, and ongoing improvement of health care systems to meet the needs of their citizens. In the United Arab Emirates, a small nation with vast wealth, the lives of average citizens have evolved from a harsh, nomadic existence to enjoyment of the comforts of modern life. Substantial progress has been made in the provision of education, housing, health, employment, and other forms of social advancement. Having covered these basic needs, the government of Abu Dhabi, United Arab Emirates, is responding to the challenge of developing a comprehensive health system to serve the needs of its citizens, including restructuring the nation's graduate medical education (GME) system. We describe how Abu Dhabi is establishing GME policies and infrastructure to develop and support a comprehensive health care system, while also being responsive to population health needs. We review recent progress in developing a systematic approach for developing GME infrastructure in this small emirate, and discuss how the process of designing a GME system to meet the needs of Emirati citizens has benefited from the experience of “Western” nations. We also examine the challenges we encountered in this process and the solutions adopted, adapted, or specifically developed to meet local needs. We conclude by highlighting how our experience “at the GME drawing board” reflects the challenges encountered by scholars, administrators, and policymakers in nations around the world as they seek to coordinate health care and GME resources to ensure care for populations.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Deborah J. Milly

PurposeThis article analyzes recent Japanese efforts to recruit care labor from seven Asian countries to identify the relative contributions to migrants and their respective countries' health systems. Besides considering the factors affecting migration from, and benefits to, sending countries, it asks how differences in the role of public and private actors may matter.Design/methodology/approachThe study uses two stages of analysis. The first uses quantitative and qualitative data for seven countries that send care labor migrants to Japan to identify differences in benefits for individual migrants and health care systems in the sending countries. The second stage examines recent initiatives for funding care worker training in Japan to assess the relative impacts of different public-private cooperative arrangements, especially in terms of Vietnam.FindingsIn addition to general migration policy mechanisms provided by the destination country, bilateral relationships and foreign assistance, along with economic, demographic and health care conditions in the origin countries, contribute to the relative benefits of migration. Among countries supplying care labor to Japan, Vietnam is obtaining the most benefits for its health care system in return.Originality/valueResponding to central concerns surrounding care labor migration, the article compares across countries sending care workers to a single country. The comparison highlights a constellation of factors that contribute the greatest benefits. The article identifies how different types of public and private relationships can influence this process. The study provides observations applicable to other welfare states developing care labor migration relationships.


2018 ◽  
Vol 29 (1) ◽  
pp. 131-147 ◽  
Author(s):  
Eduardo Botti Abbade

Purpose The purpose of this paper is to investigate the associations between obesogenic severity, the public health situation, environmental impacts, and health care expenditures in populations worldwide. Design/methodology/approach This ecological study is based on official data available for approximately 140 countries worldwide. This study defines four main variables: obesogenic severity, environmental impact, public health implications (PHI), and health expenditures, all measured through specific indicators. Data were obtained mainly from the WHO, World Bank, and IDF. The indicators were reduced to the main variables through factorial reduction and multiple regression analyses were used to test the main hypotheses. Findings Obesogenic severity strongly and positively affects environmental impacts (β=0.6578; p<0.001), PHI-1 (cardiovascular risk factor) (β=0.3137; p<0.001) and PHI-2 (blood glucose and diabetes diagnoses) (β=0.3170; p<0.001). Additionally, environmental impacts strongly and positively affect PHI-1 (β=0.4978; p<0.001) but not PHI-2. Thus, results suggest that environmental impact, PHI-1, and PHI-2 strongly affect health expenditures (β=0.3154; p<0.001, β=0.5745; p<0.001, and β=−0.4843; p<0.001, respectively), with PHI-2 negatively affecting the health expenditures. Practical implications This study presents evidence that can aid in decision making regarding public and private efforts to better align budgets and resources as well as predict the needs and expenditures of public health care systems. Originality/value This investigation finds that the main variables addressed are strongly associated at the worldwide level. Thus, these analytical procedures can be used to predict public health and health care cost scenarios at the global level.


Author(s):  
Penelope L. Burns ◽  
Gerard J. FitzGerald ◽  
Wendy C. Hu ◽  
Peter Aitken ◽  
Kirsty A. Douglas

Abstract Introduction: General Practitioners (GPs) are inevitably involved when disaster strikes their communities. Evidence of health care needs in disasters increasingly suggests benefits from greater involvement of GPs, and recent research has clarified key roles. Despite this, GPs continue to be disconnected from disaster health management (DHM) in most countries. Study Objective: The aim of this study was to explore the perspectives of disaster management professionals in two countries, across a range of all-hazard disasters, regarding the roles and contributions of GPs to DHM, and to identify barriers to, and benefits of, more active engagement of GPs in disaster health care systems. Methods: A qualitative research methodology using semi-structured interviews was conducted with a purposive sample of Disaster Managers (DMs) to explore their perspectives arising from experiences and observations of GPs during disasters from 2009 through 2016 in Australia or New Zealand. These involved all-hazard disasters including natural, man-made, and pandemic disasters. Responses were analyzed using thematic analysis. Results: These findings document support from DM participants for greater integration of GPs into DHM with New Zealand DMs reporting GPs as already a valuable integrated contributor. In contrast, Australian DMs reported barriers to inclusion that needed to be addressed before sustained integration could occur. The two most strongly expressed barriers were universally expressed by Australian DMs: (1) limited understanding of the work GPs undertake, restricting DMs’ ability to facilitate GP integration; and (2) DMs’ difficulty engaging with GPs as a single group. Other considerations included GPs’ limited DHM knowledge, limited preparedness, and their heightened vulnerability. Strategies identified to facilitate greater integration of GPs into DHM where it is lacking, such as Australia, included enhanced communication, awareness, and understanding between GPs and DMs. Conclusion: Experience from New Zealand shows systematic, sustained integration of GPs into DHM systems is achievable and valuable. Findings suggest key factors are collaboration between DMs and GPs at local, state, and national levels of DHM in planning and preparedness for the next disaster. A resilient health care system that maximizes capacity of all available local health resources in disasters and sustains them into the recovery should include General Practice.


2019 ◽  
Vol 33 (2) ◽  
pp. 241-262 ◽  
Author(s):  
Terry J. Boyle ◽  
Kieran Mervyn

Purpose Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools. Design/methodology/approach This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development. Findings This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages. Research limitations/implications The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community. Practical implications The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles. Originality/value This paper demonstrates how health care leadership can be developed and sustained.


Author(s):  
Manimay Dev ◽  
Dinesh Kumar ◽  
Dharmendra Patel

Purpose The purpose of this paper is to identify the factors that influence hospitals’ selection by health-care insurers in India and to establish a hierarchical model representing the relationship among different factors and their influence on the entire scenario. Design/methodology/approach A survey with a set of questionnaires was conducted with different health-care insurer executives of reputed health insurance companies. The data has been gathered by using a five-point Likert scale. Their opinions were converted into a reachability matrix and an interpretive structural modeling was constructed. The final results obtained were verified by using fuzzy Matriced Impacts Croises-Multiplication Applique and Classement analysis. Findings The results suggested three key driving factors, National Accreditation Board for Hospitals & Healthcare Providers accreditation of the hospital, purchasing power of people in the region and national and international recognition of the hospital among the eleven factors selected for the study. Research limitations/implications The research mainly focuses on the health insurance benefits provided by privately owned insurance companies and do not comment on any government’s mass health insurance scheme. Practical implications With a small proportion of people under the umbrella of health insurance in India, these factors will assist and expedite insurer’s effort to penetrate deep into rural and urban areas enhancing availability and escalating affordability. Originality/value This paper presents key factors responsible for better coordination between health-care systems and insurance companies.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Manu Sharma ◽  
Sudhanshu Joshi

Purpose This paper aims to identify barriers toward the adoption of blockchain (BC) technology in Indian health-care industry and also examines the significant issues of BC applications in health-care industry. Design/methodology/approach The barriers of the study are identified by two phases including the review of literature and semistructured interviews with hospital staff and administration operating in India. The experts (N = 15) are being taken from top-level management, IT experts and patients from the hospitals. The study implemented integrated total interpretative structural modeling-FUZZY-Cross-impact matrix multiplication applied to classification (TISM-FUZZY-MICMAC) methods for identifying the interrelationship among the barriers. Findings A total of 15 barriers have been determined in the Indian health-care industry through discussion with the selected experts. TISM is applied to develop multilevel structure for BC barriers. Further, FUZZY-MICMAC has been used to compute driving and dependent barriers. The findings suggest that low awareness related to legal issues and low support from high level of management have maximum driving power. Research limitations/implications The present study applies multicriterion approach to identify the limited barriers in BC adoption in health care. Future studies may develop the relationship and mark down the steps for implementation of BC in health-care setting of a developing economy. Empirical study can be conducted to verify the results along with selected case studies. Practical implications The present study identifies the BC adoption barriers in health-care industry. The study examines the pertinent issues in context to major support required, bottlenecks in adoption, key benefits of adoption planning and activities. The technology adoption practices are expected to provide applications such as distributed, secured medical and clinical data and patient centric systems that will enhance the efficiency of the health-care industry. Originality/value The study is among few primary studies that identify and analyze the BC adoption in health-care industry.


2016 ◽  
Vol 30 (1) ◽  
pp. 133-153 ◽  
Author(s):  
Elisabet Höög ◽  
Jack Lysholm ◽  
Rickard Garvare ◽  
Lars Weinehall ◽  
Monica Elisabeth Nyström

Purpose – The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development. Design/methodology/approach – A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. Findings – The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. Practical implications – A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization’s measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Originality/value – Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor’s view on important factors to consider when building a coherent organizational M & F strategy.


2020 ◽  
Vol 16 (3) ◽  
pp. 303-318 ◽  
Author(s):  
Luis Gadama ◽  
Chrissie Thakwalakwa ◽  
Chimwemwe Mula ◽  
Victor Mhango ◽  
Chikosa Banda ◽  
...  

Purpose Sub-Saharan African prisons have seen a substantial increase in women prisoners, including those incarcerated with children. There is very little strategic literature available on the health situation and needs of women prisoners and their circumstantial children in Malawi. The study aims to explore this issue. Design/methodology/approach A qualitative exploratory study using in-depth key informant interviews with senior correctional stakeholders (commissioner of prison farms, senior correctional management staff, senior health officials and senior officers in charge) (n = 5) and focus group discussions (FGD) with women in prison of age between 18 and 45 years (n = 23) and two FGD with correctional staff (n = 21) was conducted in two prisons in Malawi, Chichiri and Zomba. Narratives were transcribed and analysed using thematic analysis. Findings Three key themes emerged and are as follows: “hygiene and sanitary situation across multiple prison levels and subsequent health implications for women”; “nutritional provision and diets of women and children in prison”; and “women’s access to prison-based and external health services”. Divergence or agreement across perspectives around sanitation and disease prevention, adequacy of nutrition for pregnant or breast-feeding women, health status and access to prison-based health care are presented. Practical implications Garnering a contemporary understanding of women’s situation and their health-care needs in Malawian prisons can inform policy and correctional health practice change, the adaptation of technical guidance and improve standards for women and their children incarcerated in Malawi. Originality/value There is a strong need for continued research to garner insight into the experiences of women prisoners and their children, with a particular emphasis on health situation.


2018 ◽  
Vol 19 (4) ◽  
pp. 286-297
Author(s):  
Bret Hicken ◽  
Kimber Parry

Purpose The purpose of this paper is to provide an overview of rural older veterans in the US and discuss how the US Department of Veterans Affairs (VA) is increasing access to health care for older veterans in rural areas. Design/methodology/approach This is a descriptive paper summarizing population and program data about rural veterans. Findings VA provides a variety of health care services and benefits for older veterans to support health, independence, and quality of life. With the creation of the Veterans Health Administration Office of Rural Health (ORH) in 2006, the needs of rural veterans, who are on average older than urban veterans, are receiving greater attention and support. ORH and VA have implemented several programs to specifically improve access to health care for rural veterans and to improve quality of care for older veterans in rural areas. Originality/value This paper is one of the first to describe how VA is addressing the health care needs of older, rural veterans.


Sign in / Sign up

Export Citation Format

Share Document