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Do patient, hospital, and community characteristics predict variations in overall inpatient experience scores? A multilevel analysis of hospitals in California
The purpose of this cross-sectional study was to examine how patient, hospital, and community characteristics explain variations in overall inpatient experience with care. We used data from the Patients’ Evaluations of Performance in California survey, the American Hospital Association annual hospital survey, and the Area Resource File. The sample consisted of 24,887 adult patients who received either medical or surgical inpatient care in 173 hospitals located in 46 California counties. A null hierarchical linear model for overall inpatient experience showed that 96.17%, 3.24%, and 0.59% of the variations were within...
Source: Health Services Management Research - May 15, 2016 Category: Health Management Authors: AbuDagga, A., Weech-Maldonado, R. Tags: Primary research Source Type: research

Where health workforce governance research meets health services management
A deficit of one million healthcare workers forecasted in the European Union by 2020 turns the ‘universal truth’ that there is ‘no health without a workforce’ into the perhaps biggest challenge for future healthcare systems and services management. We argue that effective healthcare management needs systematic connections with health workforce macro- and meso-levels of governance. We seek to explore the overlaps and the benefits of closer connections using health workforce planning, recruitment and retention and the changes in the skills mix and competencies of the health workforce as three illustra...
Source: Health Services Management Research - May 15, 2016 Category: Health Management Authors: Kuhlmann, E., Batenburg, R., Dussault, G. Tags: Primary research Source Type: research

Digital health and citizen engagement: Changing the face of health service delivery
We highlight two contemporary trends that would benefit from more focused research as they have the capacity to significantly reshape health system delivery in the coming decade. The first is digital health and big data science. The second potential landslide is the growing phenomenon of patient and citizen engagement. This paper outlines the key features and rationale for how digital health and increased engagement can reshape health services, pointing to key areas that warrant careful research by healthcare management scholars. We further point to the relationship and overlap of these two areas and suggest that examining...
Source: Health Services Management Research - May 15, 2016 Category: Health Management Authors: Oborn, E., Barrett, S. Tags: Primary research Source Type: research

Co-care: Producing better health outcome through interactions between patients, care providers and information and communication technology
The demands on healthcare are shifting, from caring for patients with acute conditions managed in a single-care episode to caring for patients with chronic and often complex conditions. With this shift comes a recognition that healthcare requires an interaction between patients and care providers, and of the interdependencies between these actors for achieving a positive outcome – that the results are co-produced. This paper introduces co-care, which stresses that the role of healthcare providers is to complement people’s own resources for managing their health so that patients’ and healthcare providers&r...
Source: Health Services Management Research - May 15, 2016 Category: Health Management Authors: von Thiele Schwarz, U. Tags: Primary research Source Type: research

Can learning sets help policy managers with their wicked problems?
This paper reports on an evaluation of a national action learning set for health policy managers from three Australian state/territory health authorities, conducted during 2010–2011. We collected and analysed qualitative data about the major problems the participants encountered in their work, their experiences of the learning set and their perceptions of the outcomes. The predominant concerns of participants were ‘wicked problems’ in four areas: managing the environment, managing the policy process, managing the self and managing the policy team. Participants reported that the learning set had assisted t...
Source: Health Services Management Research - May 15, 2016 Category: Health Management Authors: Gleeson, D., Dwyer, J., Lin, V., Legge, D., Hughes, A. Tags: Primary research Source Type: research

Beyond rhetoric: What health services management research must do for research and practice
(Source: Health Services Management Research)
Source: Health Services Management Research - May 15, 2016 Category: Health Management Authors: Lega, F. Tags: Editorial Source Type: research

Developmental health services leadership: Integrating hierarchical and shared leadership for health services organizational learning
The purpose of this article is to articulate a model of, as well as a call to action for, health services leadership, with a particular emphasis on the role of health services leadership in organizational learning. More specifically, I articulate a model that poses two antecedents of health services hierarchical leadership—leader responsibility disposition and environmental cues—as important predictors of empowering leadership. In turn, I assert that empowering leadership from above will engender an inclination toward shared leadership among followers. Subsequently, I venture that both empowering hierarchical l...
Source: Health Services Management Research - December 23, 2015 Category: Health Management Authors: Pearce, C. L. Tags: Theoretical or conceptual development Source Type: research

The effect of physicians financial incentives on the diagnosis related group-based prospective reimbursement scheme in Taiwan
This study examines whether the implementation of a Physician Compensation Program (PCP) improved departmental performance in a large private not-for-profit hospital’s performance after it implemented the Taiwan Diagnosis Related Group-based (Tw-DRG) prospective reimbursement scheme. Because hospitals in Taiwan are structurally similar to staff-model HMOs, the effects of PCPs on hospital performance under the Tw-DRG scheme in Taiwan may have implications for staff-model HMOs. The data sample contains 624 monthly observations of the 26 departments in the case hospital for the period 2009–2010. Of the 26 departme...
Source: Health Services Management Research - December 23, 2015 Category: Health Management Authors: Chiang, C.-Y., Chu, H.-L., Romeis, J. C. Tags: Primary research Source Type: research

Chronic obstructive pulmonary disease mobile care: A participant-focussed and human rights-based evaluation
This study aimed, first, to explore patients’ experiences of Sweden’s first COPD mobile care programme through semi-structured interviews with twelve patients, and, second, to evaluate if a human rights-based analysis could provide additional information. Data were, first, analysed using latent content analysis, resulting in three themes: security (effective follow-up, positive encounters), availability (convenience), and suggestions for improvement (increased amount of personnel, longer enrolment period, continued follow-up upon discharge from the programme). Security and availability contributed to high accep...
Source: Health Services Management Research - December 23, 2015 Category: Health Management Authors: Ranjbar, V., Hjalmarsson, A., Ascher, H., Ekberg-Jansson, A. Tags: Primary research Source Type: research

Changes in access to and costs of overseas treatment after the introduction of universal health coverage in the Maldives: Findings from surveys and the analysis of claims data
Conclusions Despite the fact that the objectives of the two surveys differed which may have led to differences in measurements, it can be concluded that UHC has narrowed the gap between the rich and poor in utilizing medical treatment overseas. However, median out of pocket spending on MTO has increased over the years indicating the need to broaden the benefit package of the UHC program. Further research is needed on the most deprived populations who have not accessed care abroad despite the change in the health financing system in the country. (Source: Health Services Management Research)
Source: Health Services Management Research - December 23, 2015 Category: Health Management Authors: Suzana, M., Chongsuvivatwong, V. Tags: Primary research Source Type: research

The quality and implications of Balance of Care studies: Lessons from a systematic literature review
The Balance of Care approach provides a framework for assessing the relative costs and outcomes of changes in the mix of services provided for a particular client group in a defined geographical area. A 2008/2009 systematic literature review explored how five key aspects of the framework had been operationalised detailing past studies’ methods. However, little has been reported about the quality of these applications, whilst the (positive and negative, internal and external) issues associated with organisations’ capacity to implement study findings (i.e. reconfigure provision) have not been appraised. Against t...
Source: Health Services Management Research - November 23, 2015 Category: Health Management Authors: Tucker, S., Hughes, J., Brand, C., Buck, D., Challis, D. Tags: Evidence synthesis/review Source Type: research

Physician perceived market competition associated with barriers to delivery of quality care: Evidence from a national cross-sectional survey of physicians in the USA
While quality is of paramount concern in health care, there has been little research done examining physician attitudes towards quality of health care and their perceived competitiveness in the market place. Utilizing the national physician survey data (n = 4720), we undertook a bivariate and multivariate regression analysis to explore the association between physician perceived competition and barriers to quality of care. After adjusting personal and organizational factors, two quality care measures were found to be related to increased physician perceived market competition: (1) inadequate mechanism (patient’s inab...
Source: Health Services Management Research - November 23, 2015 Category: Health Management Authors: Lee, D., Rutsohn, P. Tags: Primary research Source Type: research

The cost of providing end of life care for nursing care home residents: A retrospective cohort study
Conclusions Death in hospital is costly, and is seldom identified as a preferred place of death. Therefore, interventions are needed which help nursing care home staff to identify when an individual is dying, and have the skill and confidence to make difficult decisions regarding care provision at the end of life. (Source: Health Services Management Research)
Source: Health Services Management Research - November 23, 2015 Category: Health Management Authors: Ennis, L., Kinley, J., Hockley, J., McCrone, P. Tags: Primary research Source Type: research

The mutual shaping of governance and regulation of quality and safety in Dutch healthcare
Developing the concepts of governance and regulation is path dependent: working with the complexity of governance and regulation shapes and reshapes both their meaning and form. We conducted a case study on governance and regulation of quality and safety in Dutch hospitals to reveal these processes. We found that governance was given meaning in several phases, ranging from a focus on institutional design (e.g. corporate governance) through coping with incidents and using quality measurements, to prospective risk management. Governance changed incrementally in form and practice. We also saw that governance and regulation ar...
Source: Health Services Management Research - November 23, 2015 Category: Health Management Authors: Stoopendaal, A., van de Bovenkamp, H. Tags: Primary research Source Type: research

Clinical leadership through commissioning: Does it work in practice?
In tune with much international practice, the English National Health Service has been striving to transform health care provision to make it more affordable in the face of rising demand. At the heart of a set of recent radical reforms has been the launch of ‘clinical commissioning’ using the vehicle of local groups of General Practitioners (GPs). This devolves a large portion of the total healthcare budget to these groups. National government policy statements make clear that the expectation is that the groups will ‘transform’ the organisation and provision of health services. In this article, we d...
Source: Health Services Management Research - November 23, 2015 Category: Health Management Authors: Storey, J., Holti, R., Hartley, J., Marshall, M., Matharu, T. Tags: Primary research Source Type: research