Dynamic capabilities in private hospitals: a case-based research of Henan Shengde Hospital

China's medical industry is in the stage of transformation. As new reform policies are released frequently and increasing number of private hospitals entry the medical industry, the external environment is constantly changing. Why is Henan Shengde Hospital capable to survive and prosper through market changes but others fail? This study adopts Dynamic Capability Approach and investigates the role of dynamic capabilities in achieving superior medical staff satisfaction. The main purpose of this study is to examine the importance of dynamic capabilities for Henan Shengde Hospital to cope with the external environment as well as their mediating role in the relationship between organizational resources, capabilities and medical staff satisfaction. Both exploratory and conclusive research are conducted in this study. Seven managers were interviewed and a total of 315 questionnaires were distributed and collected in Henan Shengde Hospital. The findings indicate that organizational culture and managerial capability have positive impact on employee satisfaction. Responding capability and reconfiguring capability affect employee satisfaction positively, while sensing capability does not. We also find that reconfiguring capability play a mediating role in three pairs of relationship, namely, organizational culture and medical staff satisfaction, leadership and medical staff satisfaction as well as managerial capability and medical staff satisfaction. When the organization faces a volatile and unpredictable external environment, reconfiguring capability is an important source of medical staff satisfaction.A indústria da saúde na China encontra-se numa fase de transformação. A liberação constante de novas políticas e a entrada de um número crescente de hospitais privados provocam turbulência na envolvente externa. Partimos da seguinte questão principal de investigação: porque é que o Hospital Henan Shengde é capaz de sobreviver às mudanças de mercado e outros falham? Este estudo adopta a abordagem das capacidades dinâmicas para investigar o papel destas na obtenção da satisfação do pessoal médico. O principal objetivo desta tese consiste em examinar a importância das capacidades dinâmicas para o Hospital Henan Shengde lidar com a envolvente externa assim como o seu papel mediador na relação entre os recursos organizacionais, capacidades e a satisfação do pessoal médico. Este estudo conduziu uma pesquisa exploratória e conclusiva. Sete gestores foram entrevistados e um total de 315 questionários foram distribuídos e recolhidos no Hospital Henan Shengde. Os resultados mostram que a cultura organizacional e capacidade de gestão têm um impacto positivo na satisfação dos empregados. A capacidade de resposta e a capacidade de reconfiguraçãção afetam positivamente a satisfaçãção dos empregados, enquanto a capacidade de detecçãção não afeta. Concluímos também que a capacidade de reconfiguração desempenha um papel mediador em três pares de relacionamento, nomeadamente, cultura organizacional e satisfação do pessoal médico, liderança e satisfação do pessoal médico assim como capacidade de gestão e satisfação do pessoal médico. Quando a organização enfrenta uma envolvente externa volátil e imprevisível, a capacidade de reconfiguração é uma fonte importante da satisfação do pessoal médico

Exchange of health service innovations between East and West

In the 21st century, countries worldwide face complex challenges that strain their health systems. The World Health Organization advocates for a global exchange of health innovations to promote learning among countries about solutions to common health system challenges (e.g., increasing health expenditure, aging population). Spreading innovations is like the ripple effect after throwing a pebble into a pond. It is a dynamic, non-linear process influenced by various contextual factors. Diffusion therefore cannot be “off-the-shelf” deals and contextual differences can either facilitate or hinder the process.Current scientific evidence, however, primarily documented diffusion within Western health systems. Innovation diffusion between contexts with significant differences is under-researched. How innovations diffuse between East and West remains unclear and the same applies to the transnational diffusion process. We therefore need to advance the understanding of the factors and processes of transnational diffusion of health service innovations between health systems in the East and West. With this aim, we conducted a systematic review, semi-structured interviews, and case studies in China (regarding Dutch innovations in elderly care) and The Netherlands (regarding Chinese traditional acupuncture). This PhD thesis provides novel insights into factors that facilitate and/or hinder the transnational diffusion of health service innovations between health systems in the East and West; and how these factors affect the diffusion process. We found that various factors often interact to affect the transnational diffusion of health service innovations between East and West. The structural and especially cultural fit between the innovation and the system influences transnational diffusion (innovation-system fit). Especially when strongly held norms and values in the context are not compatible with those embedded in the original innovation. When such incompatibility exists, mutual adaptations are often needed. The global journey of innovations can be facilitated by change agents whose knowledge work, culture work, and structural work serve to overcome the innovation-system fit barrier. Trust work may be additionally necessary depending on the perceived trustworthiness of change agents and on whether the innovation is ‘invited’ to the adoption context or not. Trust work may also be needed to establish a long-lasting international social network linking the country from which innovations originated, and the country into which innovations are introduced. Such international social networks are instrumental as a channel to exchange innovations, knowledge, and culture between the East and the West and provide a platform for the diverse tasks of change agents. The transnational diffusion process remains complex, non-linear, and recursive, which requires incremental steps and long-term commitment.<br/

Family Physician Access among Trans People in Ontario: A Cross-sectional Analysis of Social Determinants of Health and Inequality Issues.

For trans Ontarians with access to publicly insured health care, this study aimed to determine predictors of not having a family physician, as well as to identify factors that influence a trans patient’s comfort discussing trans status or trans-related health needs with their physician. Previously collected demographic and family physician access related data (n=433) were used. Multiple logistic predictive model showed that age, marital status, education, employment, income-to-needs ratio, and social support independently predicted not having a family physician. Marital status, negative trans-specific experience with family physicians, and perception of family physician\u27s knowledge about trans health needs were identified as important predictors of discomfort with family physicians across gender spectra. These findings will be informative in addressing the inequality issues relating to access to care in trans communities. The results may also be helpful in changing the manner in which primary care services are delivered, helping to improve trans-related physician-patient discussion

Digital Health Care in Taiwan

This open access book introduces the National Health Insurance (NHI) system of Taiwan with a particular emphasis on its application of digital technology to improve healthcare access and quality. The authors explicate how Taiwan integrates its strong Information and Communications Technology (ICT) industry with 5G to construct an information system that facilitates medical information exchange, collects data for planning and research, refines medical claims review procedures and even assists in fighting COVID-19. Taiwan's NHI, launched in 1995, is a single-payer system funded primarily through payroll-based premiums. It covers all citizens and foreign residents with the same comprehensive benefits without the long waiting times seen in other single-payer systems. Though premium rate adjustment and various reforms were carried out in 2010, the NHI finds itself at a crossroads over its financial stability. With the advancement of technologies and an aging population, it faces challenges of expanding coverage to newly developed treatments and diagnosis methods and applying the latest innovations to deliver telemedicine and more patient-centered services. The NHI, like the national health systems of other countries, also needs to address the privacy concerns of the personal health data it collects and the issues regarding opening this data for research or commercial use. In this book, the 12 chapters cover the history, characteristics, current status, innovations and future reform plans of the NHI in the digital era. Topics explored include: Income Strategy Payment Structure Pursuing Health Equity Infrastructure of the Medical Information System Innovative Applications of the Medical Information Applications of Big Data and Artificial Intelligence Digital Health Care in Taiwan is essential reading for academic researchers and students in healthcare administration, health policy, health systems research, and health services delivery, as well as policymakers and public officials in relevant government departments. It also would appeal to academics, practitioners, and other professionals in public health, health sciences, social welfare, and health and biotechnology law

Digital Health Care in Taiwan

This open access book introduces the National Health Insurance (NHI) system of Taiwan with a particular emphasis on its application of digital technology to improve healthcare access and quality. The authors explicate how Taiwan integrates its strong Information and Communications Technology (ICT) industry with 5G to construct an information system that facilitates medical information exchange, collects data for planning and research, refines medical claims review procedures and even assists in fighting COVID-19. Taiwan's NHI, launched in 1995, is a single-payer system funded primarily through payroll-based premiums. It covers all citizens and foreign residents with the same comprehensive benefits without the long waiting times seen in other single-payer systems. Though premium rate adjustment and various reforms were carried out in 2010, the NHI finds itself at a crossroads over its financial stability. With the advancement of technologies and an aging population, it faces challenges of expanding coverage to newly developed treatments and diagnosis methods and applying the latest innovations to deliver telemedicine and more patient-centered services. The NHI, like the national health systems of other countries, also needs to address the privacy concerns of the personal health data it collects and the issues regarding opening this data for research or commercial use. In this book, the 12 chapters cover the history, characteristics, current status, innovations and future reform plans of the NHI in the digital era. Topics explored include: Income Strategy Payment Structure Pursuing Health Equity Infrastructure of the Medical Information System Innovative Applications of the Medical Information Applications of Big Data and Artificial Intelligence Digital Health Care in Taiwan is essential reading for academic researchers and students in healthcare administration, health policy, health systems research, and health services delivery, as well as policymakers and public officials in relevant government departments. It also would appeal to academics, practitioners, and other professionals in public health, health sciences, social welfare, and health and biotechnology law