Analysis of the operational risk factors in public hospitals in an Indian state

2019 ◽  
Vol 33 (1) ◽  
pp. 67-88 ◽  
Author(s):  
C.R. Vishnu ◽  
R. Sridharan ◽  
P.N. Ram Kumar ◽  
V. Regi Kumar
Keyword(s):  
Risk Factors ◽  
Healthcare System ◽  
Significant Risk ◽  
Public Hospitals ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Content Type ◽  
Indian State ◽  
The Government ◽  
The Impact

Purpose Risk management in the healthcare sector is a highly relevant sub-domain and a crucial research area from the humanitarian perspective. The purpose of this paper is to focus on the managerial/supply chain risk factors experienced by the government hospitals in an Indian state. The present paper analyzes the inter-relationships among the significant risk factors and ranks those risk factors based on their criticality. Design/methodology/approach The current research focuses on 125 public hospitals in an Indian state. Questionnaire-based survey and personal interviews were conducted in the healthcare sector among the inpatients and hospital staff to identify the significant risk factors. An integrated DEMATEL–ISM–PROMETHEE method is adopted to analyze the impact potential and dependence behavior of the risk factors. Findings The analysis asserts the absence of critical risk factors that have a direct impact on patient safety in the present healthcare system under investigation. However, the results illustrate the remarkable impact potential attributed to the risk factor, namely, staff shortage in inducing other risk factors such as employee attitudinal issues, employee health issues and absenteeism altogether resulting in community mistrust/misbeliefs. Maintenance mismanagement, monsoon time epidemics, physical infrastructure limitations are also found to be significant risk factors that compromise patient satisfaction levels. Practical implications Multiple options are illustrated to mitigate significant risk factors and operational constraints experienced by public hospitals in the state. The study warrants urgent attention from government officials to fill staff vacancies and to improve the infrastructural facilities to match with the increasing demand from the society. Furthermore, this research recommends the hospital authorities to start conducting induction and training programs for the hospital employees to instill the fundamental code of conduct while working in hectic, challenging and even in conditions with limited resources. Originality/value Only limited papers are visible that address the identification and mitigation of risk factors associated with hospitals. The present paper proposes a novel DEMATEL–ISM–PROMETHEE integrated approach to map the inter-relationships among the significant risk factors and to rank those risk factors based on their criticality. Furthermore, the present study discloses the unique setting of the public healthcare system in a developing nation.

Significant risk factors associated with facilities management (FM) outsourcing

2015 ◽  
Vol 22 (6) ◽  
pp. 771-796 ◽  
Author(s):  
Dubem I. Ikediashi ◽  
Stephen O. Ogunlana
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
The Body ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Facilities Management ◽  
Content Type ◽  
Healthcare Facilities ◽  
Factors Associated ◽  
Body Of Knowledge

Purpose – The purpose of this paper is to extend the body of knowledge on healthcare facilities management (FM) by investigating the risks associated with outsourcing of FM services in hospitals. Design/methodology/approach – The paper relied on two strands of methodology common with pragmatic research. Questionnaire survey (QS) used data from 208 respondents representing ten hospitals while three out of the ten hospitals involved in the QS were selected based on their willingness to enter the case study (CS) interview. Data collected were analysed using descriptive and inferential statistics for QS and using narrative techniques by discussing themes, sub-themes for the CS. Findings – Findings established 24 out of the 35 risk factors as critical, four factors as somehow critical, and five factors as not critical. Besides, nine risk factors were found to be significantly loaded on the five risk categories. The rank analysis also revealed that the top five critical risk factors are: inexperience and lack of requisite skills; possibility of fraud by vendor; financial failure of chosen vendor; vendor opportunism; and fall in morale of employees. Originality/value – The study provides an unambiguous contribution to exiting body of knowledge on outsourcing risks as it relates to healthcare FM. It reinforces the theory that risks exist in any form of relationship but developed a distinct body of factors associated with outsourcing of FM services particularly from the context of Nigeria’s public healthcare sector.

The privatisation of healthcare system in Bangladesh

2019 ◽  
Vol 32 (1) ◽  
pp. 97-107 ◽  
Author(s):  
Redwanur Rahman
Keyword(s):  
Public Policy ◽  
Healthcare System ◽  
Health Sector ◽  
World Health ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Content Type ◽  
The Public ◽  
The World ◽  
The Government

Purpose The purpose of this paper is to examine the factors that triggered the privatisation of Bangladesh’s health sector. Design/methodology/approach This study follows systematic reviews in its undertaking and is based on an extensive review of both published and unpublished documents. Different search engines and databases were used to collect the materials. The study takes into account of various research publications, journal articles, government reports, policy and planning documents, relevant press reports/articles, and reports and discussion papers from the World Health Organization, the World Bank and the Asian Development Bank. Findings While Bangladesh’s healthcare sector has undergone an increasing trend towards privatisation, this move has limited benefits on the overall improvement in the health of the people of Bangladesh. The public sector should remain vital, and the government must remobilise it to provide better provision of healthcare. Research limitations/implications The paper focusses only on the public policy aspect of privatisation in healthcare of a country. Practical implications The paper examines the issue of privatisation of healthcare and concludes that privatisation not only makes services more expensive, but also diminishes equity and accountability in the provision of services. The study, first, makes a spate of observations on improving public healthcare resources, which can be of value to key decision makers and stakeholders in the healthcare sector. It also discourages the move towards private sector interventions. Originality/value This study is an independent explanation of a country’s healthcare system. Lesson learned from this study could also be used for developing public policy in similar socio-economic contexts.

Health of a Democracy

2021 ◽  
pp. 41-60
Author(s):  
Debasish Roy Chowdhury ◽  
John Keane
Keyword(s):  
Health System ◽  
Healthcare System ◽  
Good Health ◽  
Caste System ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Universal Healthcare ◽  
The Rich ◽  
The Government ◽  
The Right

This chapter discusses India’s health system. The Indian Constitution upholds the right of its citizens to enjoy human dignity. The country’s Supreme Court has ruled that this means the right to health is integral to the right to life and the government has a constitutional obligation to provide health facilities. But healthcare is not a fundamental right in India. There is no universal healthcare system. Instead, it has a three-tiered health system, in which the poorest go to the notionally free and suitably ramshackle public hospitals; the rich and upper middle classes access super-specialty private hospitals with hotel-like lobbies and air-conditioned suites, respectful doctors, and state-of the-art equipment; and the rest resort to low-to-middle-end private nursing homes that are a scaled-down version of the five-star corporate hospitals. The Covid-19 outbreak laid bare the denial of decent medical attention to the poor by this long-tolerated caste system of public healthcare. The chapter then looks at the relationship between democracy and healthcare. The commonplace belief that representative democracy forces competition for popular support that in turn makes contenders for power more responsive to citizens’ healthcare needs is shown not to apply to India. India’s pathetic public healthcare system and its mercenary private healthcare sector present a troubling anomaly to statistical conclusions that democracy is the nurse of good health. The murderous inequity of its healthcare system speaks of a democracy that celebrates the equality of its people and their votes, even while treating their bodies as unequal.

scholarly journals The worthiness of corporate governance in public sector the case of public healthcare sector in Greece

2014 ◽  
Vol 12 (1) ◽  
pp. 490-501
Author(s):  
Georgios K. Papachristou ◽  
Michail K. Papachristou
Keyword(s):  
Corporate Governance ◽  
Control System ◽  
Public Sector ◽  
Healthcare Services ◽  
Public Hospitals ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Corporate Governance Code ◽  
Public Healthcare Sector ◽  
The Impact

The objective of this paper is to measure the worthiness which the compliance of governance norms will provide to public organizations. We introduce the principles of corporate governance that should characterize the function of public sector and our analysis focuses on public hospitals. Sending appropriate designed questionnaires to an adequate sample of Greek public hospitals, we measure and analyze the impact that the implementation of a corporate governance code would have to hospitals’ administration, control system and communication with stakeholders. According to research’s results the implementation of a corporate governance code by public hospitals could add value to the provided healthcare services.

ISO 9001-certified public healthcare center’s efficiency and re-certification

2019 ◽  
Vol 69 (4) ◽  
pp. 794-812
Author(s):  
Rahmat Nurcahyo ◽  
Ellia Kristiningrum ◽  
Sik Sumaedi
Keyword(s):  
Research Result ◽  
Iso 9001 ◽  
Public Healthcare ◽  
Data Envelopment ◽  
Content Type ◽  
Value Differences ◽  
The Public ◽  
Healthcare Center ◽  
The Government ◽  
The Impact

Purpose The purpose of this paper is to measure the efficiency of ISO 9001-certified public healthcare center in Jakarta, Indonesia and examine the impact of “re-certification“ on the efficiency. Design/methodology/approach The sample of the research is 30 ISO 9001-certified district public healthcare centers in Jakarta. The data envelopment analysis (DEA) and the Man–Whitney U test were applied. Findings The research result showed that there is a variation in efficiency values of ISO 9001-certified public healthcare centers that this research studied. There are only 23 percent of the public healthcare centers that can be categorized as the technically efficient public healthcare center. Furthermore, this research also found that there are no significant efficiency value differences among the groups of public healthcare center based on the number of “re-certification” the center experienced. Research limitations/implications This research only involved ISO 9001-certified public healthcare center from Jakarta, Indonesia. Practical implications Registering ISO 9001 for the public healthcare center does not guarantee that the public healthcare center will have better efficiency. The government and the public healthcare center management should ensure that the ISO 9001 implementation method used by the public healthcare center is appropriate for improving the efficiency of the public healthcare center. Originality/value There is a lack of research that studied the efficiency of ISO 9001-certified public healthcare center. Furthermore, there is no research that investigates the effect of “re-certification“ on efficiency. This research fulfills the literature gaps.

scholarly journals The Impact of COVID-19 on Essential Medicines and Personal Protective Equipment Availability and Prices in Saudi Arabia

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 290
Author(s):  
Rana Aljadeed ◽  
Yazed AlRuthia ◽  
Bander Balkhi ◽  
Ibrahim Sales ◽  
Monira Alwhaibi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Supply Chain ◽  
Prescription Drugs ◽  
Personal Protective Equipment ◽  
Public Hospitals ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Protective Equipment ◽  
Short Supply ◽  
The Impact

This was a questionnaire-based cross-sectional study that explored the impact of the COVID-19 pandemic on the availability of essential medicine and personal protective equipment (PPE) in Saudi Arabia. Purposive sampling technique was used to recruit individuals working in the supply chain departments in different healthcare sectors in Saudi Arabia. One hundred and three pharmaceutical and medical supply chain employees participated in the study. Most of the participants (58.3%) were aged ≥35 years, male (65%), and pharmacists (92.2%). The majority of participants had at least two years of experience in supply chain (77.6%), worked in public hospitals (95.15%), and were mostly working at healthcare institutions located in Riyadh province (59.2%). Approximately 51% of the participants reported shortages of 10 or more essential drugs. Tocilizumab, hydroxychloroquine, lopinavir/ritonavir, ribavirin, dexamethasone, enoxaparin, interferon beta-1b, cisatracurium besylate, prednisolone, hydrocortisone, methimazole, and methylprednisolone were reported to be in shortage by at least 8% of the participants. Almost 70% of the participants reported that the pandemic did not significantly impact the prices of prescription drugs in shortage (e.g., ≥25%). Moreover, about 70% of the participants reported direct purchasing or procurement of drugs in shortage. Surgical masks, face shields, medical gowns, and N95 respirators were reported to be in short supply by 33% or more of the participants. Approximately 53% of the participants reported the prices of PPE in shortage had seen an increase by at least 25% during the pandemic. Although the COVID-19 pandemic has caused a significant disruption in the global pharmaceutical supply chain, its impact was largely manageable in Saudi healthcare institutions. This can be attributable to multiple reasons such as the effective exchange programs between hospitals and the drastic increase in public healthcare spending to ameliorate the negative impact of the pandemic on the healthcare sector.

A performance analysis of Brazilian public health: TOPSIS and neural networks application

2018 ◽  
Vol 67 (9) ◽  
pp. 1526-1549 ◽  
Author(s):  
Claudia Affonso Silva Araujo ◽  
Peter Wanke ◽  
Marina Martins Siqueira
Keyword(s):  
Public Health ◽  
Neural Networks ◽  
Predictive Ability ◽  
Performance Model ◽  
Public Hospitals ◽  
Healthcare Sector ◽  
Two Stage ◽  
Content Type ◽  
The Impact ◽  
A Performance

Purpose The purpose of this paper is to estimate the performance of Brazilian hospitals’ services and to examine contextual variables in the socioeconomic, demographic and institutional domains as predictors of the performance levels attained. Design/methodology/approach The paper applied a two-stage approach of the technique for order preference by similarity to the ideal solution (TOPSIS) in public hospitals in 92 Rio de Janeiro municipalities, covering the 2008–2013 period. First, TOPSIS is used to estimate the relative performance of hospitals in each municipality. Next, TOPSIS results are combined with neural networks in an effort to originate a performance model with predictive ability. Data refer to hospitals’ outpatient and inpatient services, based on frequent indicators adopted by the healthcare literature. Findings Despite a slight performance increase over the period, substantial room for improvement is observed. The most important performance predictors were related to the demographic and socioeconomic status (area in square feet and GDP per capita) and to the juridical nature and type of ownership of the healthcare facilities (number of federal and private hospitals). Practical implications The results provide managerial insights regarding the performance of public hospitals and opportunities for better resource allocation in the healthcare sector. The paper also considers the impact of external socioeconomic, demographic and institutional factors on hospitals’ performance, indicating the importance of integrative public health policies. Originality/value This study displays an innovative context for applying the two-stage TOPSIS technique, with similar efforts not having been identified in the healthcare literature.

Challenges of privatizing academic medical centers in Saudi Arabia and appropriate strategies for implementation

2020 ◽  
Vol 25 (1) ◽  
pp. 68-77 ◽  
Author(s):  
Ahmed Al Kuwaiti ◽  
Fahd A. Al Muhanna
Keyword(s):  
Medical Education ◽  
Saudi Arabia ◽  
Patient Care ◽  
Public Hospitals ◽  
Academic Medical Centers ◽  
Healthcare Sector ◽  
Content Type ◽  
Medical Centers ◽  
Academic Medical ◽  
The Government

PurposeA crisis in the financial sustainability of the public healthcare sector often compels governments to consider privatization. The purpose of this paper is to summarize various strategies to overcome the challenges facing the privatization of academic medical centers (AMCs) in Saudi Arabia.Design/methodology/approachIn this paper, the authors discuss the challenges faced in privatizing AMCs in delivering their core functions such as patient care, medical education and research. Further, the appropriate strategies are listed to overcome these challenges in privatization of AMCs.FindingsThe authors described the benefits of privatization that include a reduction in the financial burden on government healthcare expenditure, quick decision making and creation of new financial models to improve healthcare services. On the other hand, the profit motive of private management could create pressure on patients and may divert AMCs from their primary objectives. Therefore, it is imperative for the government to develop and implement appropriate strategies that balance the benefits of privatizing AMCs with eliminating the negative impact of privatization on patient care, medical education and research.Originality/valueThough AMCs privatization is currently feasible in Saudi Arabia, appropriate strategies are essential to overcome the challenges of its implementation. The government should frame a uniform rules and regulations prior to privatizing public hospitals so that it will fulfill the purpose in an efficient manner.

Management practices impacting on the rostering of medical scientists in the Australian healthcare sector

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jillian Cavanagh ◽  
Timothy Bartram ◽  
Patricia Pariona-Cabrera ◽  
Beni Halvorsen ◽  
Matthew Walker ◽  
...  
Keyword(s):  
Patient Care ◽  
Job Stress ◽  
Job Demands ◽  
Public Hospitals ◽  
Healthcare Sector ◽  
Content Type ◽  
The Public ◽  
Quality Of Patient Care ◽  
The Impact

PurposeThis study examines the management rostering systems that inform the ways medical scientists are allocated their work in the public healthcare sector in Australia. Promoting the contributions of medical scientists should be a priority given the important roles they are performing in relation to COVID-19 and the demand for medical testing doubling their workloads (COVID-19 National Incident Room Surveillance Team, 2020). This study examines the impact of work on medical scientists and rostering in a context of uncertain work conditions, budget restraints and technological change that ultimately affect the quality of patient care. This study utilises the Job-Demands-Resources theoretical framework (JD-R) to examine the various job demands on medical scientists and the resources available to them.Design/methodology/approachUsing a qualitative methodological approach, this study conducted 23 semi-structured interviews with managers and trade union officials and 9 focus groups with 53 medical scientists, making a total 76 participants from four large public hospitals.FindingsDue to increasing demands for pathology services, this study demonstrates that a lack of job resources, staff shortages, poor rostering practices such as increased workloads that lead to absenteeism, often illegible handwritten changes to rosters and ineffectual management lead to detrimental consequences for medical scientists’ job stress and well-being. Moreover, medical science work is hidden and not fully understood and often not respected by other clinicians, hospital management or the public. These factors have contributed to medical scientists’ lack of control over their work and causes job stress and burnout. Despite this, medical scientists use their personal resources to buffer the effects of excessive workloads and deliver high quality of patient care.Originality/valueFindings suggest that developing mechanisms to promote sustainable employment practices for medical scientists are critical for the escalating demands in pathology.

scholarly journals The impact of socio-demographic factors on the survival of cancer patients in Zimbabwe

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Idika E. Okorie ◽  
Ricardo Moyo ◽  
Saralees Nadarajah
Keyword(s):  
Risk Factors ◽  
Survival Analysis ◽  
Marital Status ◽  
Cancer Patients ◽  
Hazard Rate ◽  
Significant Risk ◽  
Demographic Factors ◽  
Female Cancer Patients ◽  
Socio Demographic Factors ◽  
The Impact

AbstractWe provide a survival analysis of cancer patients in Zimbabwe. Our results show that young cancer patients have lower but not significant hazard rate compared to old cancer patients. Male cancer patients have lower but not significant hazard rate compared to female cancer patients. Race and marital status are significant risk factors for cancer patients in Zimbabwe.

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